WAG 18-05-15-b: AABD Case

SWAP cash cases found eligible for QMB Only to Category 91, 92, or 93 (see WAG 18-02-02). For these cases and for medical cases eligible for QMB Only:

  1. Complete Form 552:
    • Item 2 -Enter the current processing month and year (MM/YY).
    • Item 3 -For a SWAP action, enter the appropriate TA (see WAG 18-02-02). For a medical case, enter 31.
    • Item 33 -For a SWAP action, enter the appropriate TA (see WAG 18-02-02). For a medical case, enter 41.
    • Item 60 -Change the status indicator code after QMB to 9 (see WAG 06-12-02-a).
    • Item 80 -For a cash case, delete the needs code. For a medical case, delete the spenddown code (390 SPD or 391 SPDGC) of the long term care credit code (395 GCARE), if present.
  2. Send Form 157 to tell the client that cash and/or medical is ending. Add:

(Client's name) will continue to receive assistance with Medicare cost sharing expenses as a Qualified Medicare Beneficiary (QMB).