Updated Social Security Administration (SSA) Field Office Instructions Regarding Premium- Part A Enrollments for Individuals Who Wish to Apply for the Qualified Medicare Beneficiary (QMB) Program

The Centers for Medicare & Medicaid Services (CMS), Medicare-Medicaid Coordination Office (MMCO) is pleased to announce the following updates: Updated Social Security Administration (SSA) Field Office Instructions Regarding Premium-Part A Enrollments for Individuals Who Wish to Apply for the Qualified Medicare Beneficiary (QMB) Program Training Opportunity: Best Practices for Meeting the Behavioral Health Needs of Dually Eligible Older Adults Webinar   Updated Social Security Administration (SSA) Field Office Instructions Regarding Premium- Part A Enrollments for Individuals Who Wish to Apply for the Qualified Medicare Beneficiary (QMB) Program The Social Security Administration (SSA) has revised its program instructions for field offices to process Part A enrollments for individuals who must pay a premium to enroll in Part A (Premium-Part A) and who intend to apply for the Qualified Medicare Beneficiary (QMB) at the state Medicaid office.  Additional information about the update can be found at the following link: http://policynet.ba.ssa.gov/poms.nsf/lnx/0600801140.  The QMB program provides Medicaid coverage of Part A premiums and other costs for low income Medicare beneficiaries.  QMB is an eligibility category under the Medicare Savings Programs. SSA’s updated program instructions clarify that a person not yet determined by the state to be a QMB can use the conditional enrollment process to enroll in Premium-Part A.  The conditional enrollment process allows an individual to apply for Premium-Part A but only get the coverage if the state approves the QMB application. If the state denies the QMB application, the individual will not be enrolled in Premium-Part A. The conditional enrollment process is necessary because an individual must have Part A in order to qualify for the QMB Program, however, most low-income individuals who are not eligible for Premium-Free Part A cannot afford to pay the Part A premium before obtaining QMB.  The conditional enrollment process addresses this problem by allowing the individual to enroll in Premium-Part A on the condition that the state approves the individual’s QMB application. The revised instructions also specify that individuals who live in a Part A Buy-in state (36 states and D.C) can enroll conditionally in Premium-Part A at any time while individuals who live in a Group Payer state (14 states) can only enroll in Medicare Premium Part A during a prescribed enrollment period. Training Opportunity: Best Practices for Meeting the Behavioral Health Needs of Dually Eligible Older Adults Webinar  This interactive webinar will discuss common behavioral health conditions and related challenges among dually eligible older adults, identify best practices for treatment options and care coordination, and demonstrate practical strategies for meeting beneficiary needs.  Twenty-five percent of adults in the United States who are 65 or older experience a behavioral health issue, yet only 3% of these individuals report seeking treatment from a behavioral health professional.[1] [2]  Speakers, including a family caregiver, will discuss firsthand experiences, lessons learned, and strategies to coordinate care for dually eligible older adults across diverse settings. Date/Time: August 2nd, 2018 at 2:00-3:00PM (EST) Registration Link: https://www.resourcesforintegratedcare.com/GeriatricCompetentCare/2018_GCC_Webinar_Series/Behavioral_Health_Needs Intended Audience: This webinar is intended for a wide range of stakeholders – front-line staff at social service agencies, providers and health care professionals (such as physicians, psychologists, nurses, social workers, certified prevention specialists, addiction counselors), MMPs, D-SNPs, managed long-term services and supports programs, and consumer organizations. CE Credit Information: Continuing Education (CE) credit from CMS’ Learning Management System will be available at no cost to webinar attendees.  The Centers for Medicare & Medicaid Services (CMS) – CMS is accredited by the International Association for Continuing Education and Training (IACET) and is authorized by IACET to offer CEUs. [1] National Council on Aging. (2018). Healthy Aging: Fact Sheet. https://www.ncoa.org/wp-content/uploads/2018-Healthy-Aging-Fact-Sheet.pdf. [2] U.S. Department of Health and Human Services, Administration on Aging. (2001). Older adults and mental health: Issues and opportunities. https://www.public-health.uiowa.edu/icmha/training/documents/Older-Adults-and-Mental-Health-2001.pdf.

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