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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 53 Chapter 23 Specific Medicaid Requirements

NOTE: SSI Medicaid recipients who are also entitled to premium-free Medicare Part A and/or enrolled in Medicare Part B are automatically determined to have met the above requirements and are deemed eligible for Qualified Medicare Beneficiary (QMB) without an application. There will not be a QMB category dually coded with MSS in the eligibility system at this time, instead the deemed QMB eligibility is being maintained in the MMIS system. The deemed QMB coverage begins the first day of the month following the month of eligibility. 23.12.1.A Medical ID Card Issuance The Medical ID card is included in all Medicaid approval notices. The Medical ID card does not include any date parameters since eligibility may terminate. 23.12.1.B Period of Eligibility The beginning date of QMB eligibility is the first day of the month following the month the application is approved. The usual three-month period for backdating eligibility does not apply to QMBs. However, Section 1.16 describes some situations in which backdating applies. When the individual falls within the QMB income range and qualifies for that coverage, he cannot be approved for SLIMB to obtain backdated premium payment. 23.12.1.C Reimbursement of Medicare Premium Amount Once the Buy-In Unit includes the QMB client in the State Buy-In process, and thus begins the State's payment of the client's Medicare premium to the Social Security Administration (SSA), SSA refunds all the Medicare premiums withheld during the time that the State should have paid the premium. Such reimbursement to the client does not affect the client's eligibility. 23.12.1.D Changes to Buy-In Status