WAG 06-24-03 Disposition

PM 06-24-03

new textApprovals

Cases are approved/processed in AIS or IPACS.

  • Cases changed from enrolled to active, do not require the entry of Item 77.
  • If the participant previously received HBWD and has unpaid premiums, the worker enters the unpaid premium amount with Item 80 code 149 HBWDB.
  • AIS enters Item 80 code 146 CUI, code 147 CEI, and code 148 HBWDP based on information entered by the worker.
  • When the participant pays their first month's premium, the system changes the case from "enrolled" status to active status with a TA 31/ TAR B2.
  • If the participant pays premiums for backdated months, the system authorizes coverage for these months with a TA 55/TAR 50.
  • The worker enters in Item 77 the first month the participant met the financial and nonfinancial eligibility requirements for HBWD.

Approved cases are mailed the following forms:

  • Form HFS 458MB/MBS-Approval Notice;
  • Form HFS 3712MB/MBS-To Start Your Coverage; and
  • Form HFS 2379MB/MBS-Additional Months of Coverage Form.


Use TA 31/TAR B8 to add QMB or SLIB benefits to an HBWD case after approval, if necessary.