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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL Division of Welfare and Supportive Services D-540.5 Medical Assistance Manual CHANGES 24 Jan 25 MTL 02/24 QMB/SLMB/QI1 Only to Medicaid with QMB/SLMB d. Update the appropriate information/STAT screens in the system, view and post a correct version to update the aid code, eligibility code, and notify the customer of the change in benefits. Ensure QMB/SLMB eligibility code is not removed if posting past months.

D-540.6 Medicaid Only to Medicaid with QMB/SLMB

a. Verify current Medicare Part A enrollment/effective date of entitlement.

b. Evaluate current resources and compare to Medicare beneficiary program resource limits. If information on resources is not provided, re-evaluate for the appropriate Medicaid category.

Note: Does not apply to SSI cases, as the resource evaluation is completed by Social Security. c. Update the appropriate information/STAT screens in the system, view and post a correct version to update the aid and eligibility code. Notify the customer of the change in benefits.

Note: When Converting from MAGI Medicaid to QMB, the (ineligible) first month of QMB must be posted in the last month of Medicaid eligibility to prevent a break in Medicaid coverage.

Note: AM1 and CA recipients cannot be eligible for Medicare and remain Medicaid eligible; convert to QMB/SLMB only.

D-540.7 Medicaid - QMB/SLMB to QMB/SLMB/QI1 Only

a. Update the appropriate information/STAT screens in the system, view and post a correct version to update the aid and eligibility code. Notify the customer of the change in benefits allowing for adverse.

D-540.8 Medicaid - QMB/SLMB to Medicaid Only

a. Evaluate current monthly income; do not request verification unless a change in income occurs.

b. Notify the customer of the change in benefits allowing for adverse action.

D-540.9 Katie Beckett to SSI

a. If a child becomes SSI eligible, terminate eligibility under Katie Beckett and approve SSI eligibility the following month. The following are examples of conversions:

1. Applicant applies in December as a state institutional case and is currently enrolled in Medicare Part A. The customer cooperates and is determined eligible as a state institutional case in December. Because this customer has Medicare Part A, the case manager must also determine whether the customer is eligible for QMB coverage. If the customer’s income and resources meet QMB criteria, QMB coverage is effective January.