SR 15-08 Dated 01/15

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases updates to the Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB), and Specified Low Income Medicare Beneficiary 135 (SLMB135) resource limits, pursuant to 42 USC 1396d(p)(1)(C).

BACKGROUND

The Centers for Medicare & Medicaid Services (CMS) generally releases the annual updates to the QMB/SLMB/SLMB135 resource limit in mid to late-November, so these figures are often released with the annual January Mass Change along with other annual updates associated with the adult programs of assistance. This year, CMS did not confirm the revised resource limits until December 30, 2014, which was too late to include in the January project.

POLICY

The QMB/SLMB/SLMB135 resource limits have increased to:

·      $7,280 for an individual (from $7,160); and

·      $10,930 for a couple (from $10,750).

These limits are determined by subtracting the $1,500 allotment for burial expenses from the 2015 resource limits of $8,780 (or $3,000 from $13,930, if married) for low-income subsidy (LIS), as authorized under 42 USC 1396d(p)(1)(C).

NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

The increased QMB/SLMB/SLMB135 resource limits have been coded into New HEIGHTS for a January 1, 2015 effective date.

UNRELATED OR RELATED TECHNICAL CORRECTION

In an inadvertent oversight during the release of DFA SR 14-04, dated January 2014, policy in the Medical Assistance Manual (MAM) PART 511, INCOME TYPES: BENEFITS, was not updated to reflect that worker’s compensation is not counted when determining eligibility for the medical assistance categories that use modified adjusted gross income (MAGI) in the eligibility determination process. This page has now been corrected to reflect this policy.

POLICY MANUAL REVISIONS

Revised Medical Assistance Manual Topics

Section 407.07  QMB, SLMB, and SLMB135 Resource Limits

PART 511  INCOME TYPES: BENEFITS

IMPLEMENTATION

The policy released in this SR is effective January 1, 2015.

CLIENT NOTIFICATION

No special client notification is planned or needed. The following web page has been updated with the 2015 resource limit figures: http://www.dhhs.nh.gov/dfa/medicare/eligibility.htm

TRAINING

No special training is planned or needed.

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective February 2, 2015. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Medical Assistance Manual.

DFA/JBV:s