Good Afternoon,

Please see this important message from CMS regarding conditional enrollment. The link in the message below doesn’t work so try this one. https://secure.ssa.gov/apps10/reference.nsf/links/06212018094607AM

 

Please share with your colleagues and let us know if there are ongoing problems with conditional enrollment in your state.

 

Leslie

 

 

Hi all,  

 

We’re writing to let you know that SSA has released revisions to the POMS (SSA program instructions) regarding how to process Part A enrollments that are conditional to a state’s determination of a beneficiary as a Qualified Medicare Beneficiary (QMB).  You can find the update here.  

 

The update is intended to address inconsistencies and confusion in SSA field offices and help smooth the path for QMB enrollment. It includes important clarifications, such as:

• The conditional enrollment process applies in both Part A Buy-in and Group Payer states.
• Field Offices should explain the QMB program and conditional enrollment process if an individual lacks premium-free Part A and appears to meet QMB requirements.
• SSA field offices can add notes to the “Remarks” section of the application and provide a screen shot to the individual so the individual can provide proof of conditional Part A enrollment when applying for QMB through the state.
• Beneficiaries are allowed to complete the conditional application even if they owe Medicare premiums.
• In Part A Buy-in states, SSA should process conditional applications on a rolling basis (without regard to enrollment periods), even if the application coincides with the General Enrollment Period.

 

CMS will be working with SSA to educate states about the update and provide technical assistance in the coming months.

We would welcome your help in disseminating this information and in identifying its impact and issues that remain.  

 

All my best,

Kim

 

Kim Glaun

Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office (MMCO))

Centers for Medicare & Medicaid Services (CMS)

xxxxxx@cms.hhs.gov

410-786-3849

 

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