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MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID Example #2 (Medicaid/QMB): Client applied for Medicaid/QMB on June 2nd and requests 3 months prior medical. In June, QMB eligibility is established and benefits begin effective July 1st. Then Medicaid eligibility is established July 20th back to March. Medicare premiums may be deducted for March, April, May and June only. Effective July and ongoing, the premiums are subject to third–party payments as QMB coverage began in July. 6. Expenses Incurred For Medical Care Deduct expenses incurred by the client for necessary medical care recognized under the state law but not covered under the Medicaid Program. This includes medical expenses incurred more than three months prior to the date of application. Client/Representatives must advise the agency and submit proof of the expenses. The case manager will attach a copy of the medical bill plus all related medical records to Form 2536 and submit to DHCFP for approval. These expenses must not be paid or subject to payment by a third party. DHCFP approval is required to assure the deduction is for necessary care payable to reasonable limits. c. The deficit, if any, is the client’s share of facility cost (PATIENT LIABILITY). F-325.5 LONG TERM CARE SERVICES PATIENT LIABILITY BUDGETING PROCEDURES Division of Welfare and Supportive Services Medical Assistance Manual 24 Sept MTL 05/24