B-6500, Denials

Revision 25-2; Effective June 1, 2025

Before denying a Medicaid application for any reason explore eligibility for all Medicaid and Medicare Savings Programs. This includes both Modified Adjusted Gross Income (MAGI) and non-MAGI types of assistance (TOAs).

Example: An applicant for nursing facility coverage must also be tested for Qualified Medicare Beneficiary (QMB) coverage. If the applicant is ineligible for nursing facility coverage but eligible for QMB, certify the applicant for QMB. Indicate on the notice that the applicant is ineligible for nursing facility coverage but eligible for QMB coverage.