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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 174 Chapter 1 Application/Redetermination Process

The QMB, SLIMB or QI-1 recipient is the payee. When there are eligible spouses, the spouses choose the payee. 1.16.9 BEGINNING DATE OF ELIGIBILITY 1.16.9.A QMB The beginning date of eligibility for QMB is the first day of the month following the month in which the application for QMB coverage is approved. Eligibility for QMB cannot be backdated unless there is a corrective action. QMB Beginning Date of Eligibility Example: Ms. Willow applies for LIS at the SSA on October 26, 2016 and expresses an interest in MPA. This is her LIS/MPA application date. She returns her DFA-QSQ-1 with all verifications on October 29, 2010, but they are misplaced. The Worker takes corrective action in December 2016 and notes the LIS application date in October. Since the client was otherwise eligible in October, the Worker backdates the QMB with a beginning eligibility date of November 2, 2016 and approves her for QMB effective December 2016. Even though Ms. Willow’s LIS application date is in October, QMB is effective the month following the month in which the application is approved. QMB cannot be backdated to November 2010. 1.16.9.B SLIMB The beginning date of eligibility for SLMB is the first day of the month in which the application for SLIMB coverage is approved. Eligibility for SLIMB coverage may be backdated up to three months prior to the month of application, if all eligibility requirements were met. SLIMB Beginning Date of Eligibility Example: Mr. Cedar applies for LIS at the SSA on October 29, 2015 and expresses an interest in MPA. This is his LIS/MPA NOTE: When the individual falls within the QMB income range and qualifies for that coverage, he is not approved for SLIMB to obtain backdated premium payment.