WAG 06-13-03: Family Community Resource Center Approval

PM 06-13-03

  1. (CO) Verifies Medicare Part A and Part B enrollment, through BENDEX.
  2. (CO) Generates monthly list, called "Potential Medicaid/SLIB Eligible Cases", of cases with Item 90 income of more than $25 plus SLIB income limit for a single person. List shows cases which Family Community Resource Center must review.

    Cases are listed when: 

    • for Category 91, 92, and 93 cases, code HIB and 4 is centrally added in Item 60, no SMIB status indicator appears, and a code HIB status indicator did not previously appear; and
    • code 390 SPD or 395 GCARE appears in Item 80.

      The list shows the: 

    • case name,
    • case ID number,
    • RIN, and
    • total income amounts from Item 90.
  3. (FCRC) Use Form 2382M to decide if monthly countable income is within SLIB income limit.

    NOTE: Spenddown clients are SLIB eligible if they have income above QMB income limit, but at or below SLIB limit. Spenddown enrollment shows that other SLIB eligibility requirements are met. 

  4. (FCRC) Enter following on Form 552 when applicant is SLIB eligible:
    Item 3 -TA 31.
    Item 33 -TAR 41.
    Item 60 -Social Security/Medicare Claim Number or Railroad Retirement Claim Number. Enter month/year of SLIB eligibility and status indicator 2 following Code QMB. SLIB eligibility may be effective 3 months before application.
  5. (FCRC) Send SLIB eligible applicant or caretaker the Notice Regarding Medicaid Payment of Medicare Part B Premiums (Form 3420).

NOTE: Send Form 3420 to each client converted to SLIB status by Family Community Resource Center, whether or not they appear on "Potential Medicaid/SLIB Eligible Cases" list.