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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD B-310 MAABD MEDICAL CATEGORIES Division of Welfare and Supportive Services Medical Assistance Manual 25 Mar MTL 02/25 MEDICAL BENEFICIARIES enrollment. Once proof of enrollment is received, post QMB eligibility and send an email to the DHCFP Buy-In Inbox (buyin@dhcfp.nv.gov) requesting accretion for both Part A and Part B effective the first month of QMB. DHCFP will alert SSA that the customer’s premiums are being paid by the State and the “conditional” piece of their Part A will be removed allowing the customer to be enrolled into premium- free Part A and Part B Medicare and Buy-In. If the customer does not return proof of enrollment into Medicare within 20 days, deny MAABD due to non-cooperation. Note: Coverage of Part A premiums is available only to QMB recipients. SLMB and QI covers Part B only. If a customer appears to be eligible for SLMB or QI, do not send them to enroll into Conditional Part A. If the aged applicant appears to have worked the 40 quarters (10 years) necessary for free Part A, either by working or deemed from a spouse, pend for enrollment into free Part A only. Do not send them with the Conditional Part A Enrollment form, as Conditional Enrollment into Part A is only necessary for individuals who do not have free Part A. Allow 20 days in which to provide proof of enrollment. Once received, DWSS will initiate Part B from the first month of approval by a manual accretion performed by DHCFP, thereby avoiding any billing to the customer for Part B. Send an email to the Buy-In Inbox (buyin@dhcfp.nv.gov) once QMB, SLMB, or QI is approved, requesting the accretion to Part B. If the customer does not return proof of enrollment into Medicare within 20 days, deny MAABD due to non- cooperation. Note: For ongoing full Medicaid recipients who become entitled to Medicare see section C-605.1. Note: Individuals eligible for Medicare are not eligible to receive benefits under the NCU, CH1, AM1 or CA groups. B-310.1 Low Income Subsidy (LIS) Referrals Individuals eligible for Social Security’s LIS program receive reduced premium payments for their Part D prescription drug program. The Social Security Administration transmits applicant information from LIS applicants to DWSS. DWSS must treat this data as an application for the Medicare Beneficiary programs. Application processing timeframes are determined by the date the file is received by DWSS. The eligibility determination is established based on the date the LIS application was received by Social Security. QMB effective dates remain the same when processing LIS referral applications. Example: LIS file is received by DWSS on January 29, 2024. Application effective date (date LIS application is received at Social Security) is December 2, 2023. Applicant meets all eligibility requirements for QI eligibility, decision date is February 20, 2024, first month of eligibility would be December 2023. If the same applicant was determined eligible for QMB, first month of eligibility would be March 2024. B-310.2 Qualified Medicare Beneficiaries (QMB) Covers only Medicare co-pays, premium and deductible charges for individuals who: a. Are currently enrolled or eligible to enroll in Medicare Part A; and