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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD B-305 MAABD MEDICAL CATEGORIES AGED BLIND AND DISABLED Division of Welfare and Supportive Services Medical Assistance Manual 25 Mar MTL 02/25 Aged Individuals -must be 65 years or older. Blind – determined blind according to Social Security Administration criteria. Disabled Individuals – individual must meet the disability criteria established by the Social Security Administration (SSA). The determination can be made by Social Security or the Division of Health Care Financing and Policy (DHCFP). B-310 MEDICARE BENEFICIARIES The Medicare Beneficiary program provides qualified Medicare eligible individuals with coverage of their Medicare premiums, as well as co-pays and deductibles for some qualified beneficiaries. Individuals enrolled in the Medicare Beneficiary program are also entitled to have reduced Part D prescription drug premiums through Social Security’s Low-Income Subsidy program. Individuals eligible under the QMB and SLMB Medicare Beneficiary groups may also be eligible for full Medicaid benefits under the AM, SSI, Institutional and Home-Based Waiver categories. These individuals are referred to as dual eligible. When an applicant is enrolled in Medicare Part A but is not enrolled in Part B, do not make them apply for Part B. Part B can be initiated by accretion to the Buy-In. Add the MEDI record, and post eligibility. This will generate an accretion request by the system and allow enrollment at no cost to the recipient. If an open enrollment start date is reflected in the SOLQ, Medicare Beneficiary eligibility will override the open enrollment start date. Note: For ongoing full Medicaid recipients who are enrolled in Part A only, see Section C-605.1. When an applicant is already enrolled in Part B, but is not enrolled in Part A, do not make them apply for Part A. Add MEDI record and post eligibility to cover their Part B premium. If they are QMB, the system will generate an accretion request to initiate Part A at no cost to the recipient. When an applicant is aged and has met the 5-year bar citizenship requirement but has never enrolled into Medicare and does not qualify for full Medicaid - add MEDI record based on their entitlement to enroll, then post eligibility. Complete a Public Welfare Accretion (PWA) letter and advise the customer to present the completed form to Social Security when they apply for Medicare. The PWA form allows enrollment at no cost to the recipient. Allow the individual 10 days from their first day of eligibility to provide verification of enrollment. Terminate the case for noncooperation if they do not enroll. NOTE: PWA is needed for customers who DO NOT qualify for the premium free Medicare Part A and whose countable income would be at the Medicare Savings Program level of SLMB, QI and/or QDWI. Conditional Part A – If an aged applicant appears to have not worked the 40 quarters (10 years) necessary for free Part A and appears to be eligible for QMB only, pend for enrollment into Conditional Part A and Part B. Complete the Conditional Part A Enrollment Form (2776-EM) and advise the customer to take the form to SSA to enroll into Conditional Part A and Part B. Allow 20 days in which to provide proof of