Once again there was a communication error between the Social Security Administration (SSA) and the state while processing the records for Qualified Medicare Beneficiary (QMB) applicants who applied during the Medicare open enrollment period of January through March 2011. There are two types of impacts: 1) some people still show pending Medicare Part A status in the SSA and state systems after July 2011 and 2) others had their Medicare Part A status restored, but the QMB buy-in did not take place. DHCS issued corrective instructions to the Counties, and Counties must report final resolution of all cases to DHCS no later than May 15, 2012. Download
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
medicare
ACWDL 05-24: Processing Qualified Medicare Beneficiary Cases When Eligibility Has been Erroneously Discontinued (8/5/05)
Directs counties how to reinstate eligibility for Qualified Medicare Beneficiary Program (QMB) cases that are erroneously discontinued through no fault of the beneficiary. Eligibility can be reinstated for months when the beneficiary should have been receiving benefits. Medi-Cal must retroactively pay for all past-due Medicare premiums. [Download]
ACIN I-63-05 – New Medicare Prescription Drug Plans (Part D) (October 3, 2005)
Initial information about the affect of the Medicare Part D program (phasing out the Drug Discount Card, beginning January 1, 2006.) As a result, the Food Stamps program will return to the former policy of considering only unreimbursed out-of pocket expenses for prescription drugs for determining a household’s medical deduction. “Implementation of Part D may require that Food Stamp Program county staff assist applicants in filing out applications for Part D enrollment. However, eligibility determinations for enrollment will be made by the Social Security Administration.” The letter also includes a Q & A. [Download]
DHS ACL 04-03 – Medicare-Approved Prescription Drug Discount Card Program (March 1, 2004)
Informs counties that the new Medicare Prescription Drug, Improvement and Modernization Act of 2003 signed into law on December 8, 2003 will provide Medicare beneficiaries discounts on prescription drugs through a discount card program with a $600 annual subsidy for certain low-income individuals and prescription drug coverage. For more information about the discount drug card program and the subsidy, go to CalMedicare.org.
The new drug coverage begins in January 2006 and is referred to as Medicare Part D. In 2006, dual eligibles (persons with Medi-Cal and Medicare) will receive their prescription drug coverage through Medicare Part D. This letter just hints at how the new Medicare drug coverage will impact Medi-Cal beneficiaries. It’s safe to say that major changes are in store for Medi-Cal beneficiaries and how they get their prescription drugs. Watch for more information and guidance on Medicare Part D for dual eligibles. [Download]