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North Carolina Department of Health and Human Services Division of Medical Assistance Medicaid Eligibility Unit AGED, BLIND, AND DISABLED MEDICAID MANUAL Transmitted by Change No. 12-05

MA-2150

AGED, BLIND AND DISABLED- MEDICAID WORKING DISABLED 02/01/05

MA-2150: MEDICAID-WORKING DISABLED 02/01/05

I INTRODUCTION TO M-WD

An eligible Qualified Disabled Working Individual (M-WD, Working Disabled) is eligible for Medicaid payment of Medicare Part A premiums after automatic entitlement to free Part A ends. This is the only Medicaid benefit to which he is entitled.

UNLESS OTHERWISE NOTED BELOW, THE SAME REQUIREMENTS AND PROCEDURES APPLY TO M-WD AND MQB-Q.

II. MWD ELIGIBILITY REQUIREMENTS

To be eligible to receive this coverage, an individual must:

A. Be under age 65.

B. Have countable monthly income under 200% of the Federal Poverty Level (FPL).

Refer to MA-2260, Financial Eligibility Requirements/PLA, for current income levels.

C. Continue to have the disabling physical or mental impairment that he had when he was determined disabled or blind by the Social Security Administration (SSA).

D. Have lost entitlement to premium free Medicare Part A solely due to earnings in excess of the Substantial Gainful Activity threshold as determined by SSA.

NOTE: This is a standard set by SSA. SSA will make this determination.

E. Not be otherwise entitled to premium free Medicare Part A.

F. Furnish his Medicare claim number.

G. Not be otherwise eligible for Medicaid.

III. M-WD SPECIAL REQUIREMENTS

A. Limited Coverage

M-WD covers the Medicare A premium (hospital insurance) only. If the individual wants Part B (medical insurance), he must pay for it.

B. Application Processing Requirements

1. Obtain applicant’s signature on the DSS-8124 or the DMA-5008. Complete the DMA-5008. Do not enter a DSS-8124 into EIS.

2. The time standard for M-WD application is 45 days. Manually track and follow processing requirements in MA-2300 through MA-2304.

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