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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 54 Chapter 23 Specific Medicaid Requirements

The eligibility system notifies the Buy-In Unit when the case is closed. 23.12.1.E Nursing Facility Services Those eligible as QMBs are eligible to have their QMB coverage pay the Medicare deductible and/or co-insurance for nursing facility services if Medicare is paying for nursing facility services. If the client applies for Medicaid nursing facility services as described in Chapter 24 and is found eligible, he is treated as a dual eligible. However, if the client does not apply for Medicaid nursing facility services or is not eligible for them, his QMB coverage pays the Medicare co- insurance and/or deductibles related to nursing facility costs without a client contribution for his cost of care. See Section 24.7.2.A for additional information. 23.12.2 SPECIFIED LOW-INCOME MEDICARE BENEFICIARIES (SLIMB) Income Assets 101 – 120% FPL $9,950– Individual $14,910 – Couple Medicaid coverage is limited to payment of the Medicare Part B premium. An individual or couple (spouses) is eligible for this limited Medicaid coverage when all of the following conditions are met: • The individual must be enrolled in Medicare, Part A. He must be entitled in any of the following three ways: o By being age 64 years and 9 months old or older; o By having been totally and continuously disabled and receiving RSDI or Railroad Retirement benefits for 24 months or longer; or, o By having end-stage renal disease; • The individual or couple must meet the income test detailed in Chapter 4; and, • The individual or couple must meet the asset test detailed in Chapter 5. 23.12.2.A Medical ID Card Issuance