PERMANENT RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Purpose: The rule is amended to reflect a name change for one of the Medicare savings program (MSP) eligibility categories and to meet the department's clear and concise rule-writing requirement.
Citation of Existing Rules Affected by this Order: Amending WAC 388-416-0035.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530.
Other Authority: 42 U.S.C. 1396a(a) (Section 1902 (n)(2) of the Social Security Act of 1924).
Adopted under notice filed as WSR 04-21-059 on October 18, 2004.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: December 8, 2004.
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
3462.1(a) Is for twelve months; and
(b) Begins the first day of the month following the month of QMB eligibility determination; and
(2) The certification period for the qualified disabled working individual (QDWI) program:
(a) Is twelve months; and
(b) May begin up to three months prior to the month of application if on the first day of the first month of the certification period the person:
(i) Is or had been enrolled in Medicare Part A; and
(ii) Meets or has met the department's eligibility requirements for QDWI.
(3) The certification period for the:
(a) Special low income medicare beneficiary (SLMB) program is twelve months in duration;
(b) Expanded special low income medicare beneficiary (ESLMB) program extends to the end of the calendar year.
(4) The certification periods for SLMB and ESLMB may begin up to three months prior to the month of application if on the first day of the first month of the certification period the person:
(a) Is or has been enrolled in Medicare Part B; and
(b) Meets or has met the department's eligibility requirements for SLMB or ESLMB.
(5) The certification period for SLMB coverage is twelve months in duration.)) Certification periods for the different kinds of Medicare savings programs are not all the same. The chart below explains the differences.
| Medicare Savings Program | Certification Period | Start Date |
| QMB (qualified
Medicare
beneficiary) S03 |
12 months | On the first day of the month following QMB eligibility determination |
| SLMB (Special low
income Medicare
beneficiary) S05 |
12 months | Up to three
months prior to
the certification
period if on the
first day of the first
month of
certification, the
person: • Is or has been enrolled in Medicare Part B; and • Meets SLMB eligibility requirements. |
| QDWI (Qualified
disabled working
individual) S04 |
12 months | Up to three
months prior to
the certification
period if on the
first day of the first
month of
certification, the
person: • Is or has been enrolled in Medicare Part A; and • Meets QDWI eligibility requirements. |
| QI-1 (Qualified
individual) S06 |
Thru the end of the calendar year following QI-1 eligibility determination | Up to three
months prior to
the certification
period if on the
first day of the first
month of
certification, the
person: • Is or has been enrolled in Medicare Part B; and • Meets QI-1 eligibility requirements. |
[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-416-0035, filed 7/31/98, effective 9/1/98. Formerly WAC 388-521-2150, 388-521-2155 and 388-521-2160.]