10-01 Version of 32.8 Medicare Beneficiaries Backdating
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State of Wisconsin
Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

32.8 Medicare Savings Programs Backdating

32.8.1 QMB Backdating

32.8.2 SLMB, SLMB+,QDWI Backdating

32.8.1 QMB Backdating

Occasionally, the benefits of a person who is eligible for QMBQualified Medicare Beneficiary did not begin on the first of the following month as they were supposed to.  This can occur if:

  1. The eligibility process was not completed within 30 days.

  2. Certification of eligibility was not completed.

  3. A fair hearing decision has ordered backdated QMB benefits.

 

To backdate QMB benefit, complete an F-10110 (formerly DES 3070)  certification form and return to:

 

  1. Mail:

HP Enterprise Services

P.O. Box 7636

Madison, WI 53707

 

  1. Fax: (608) 221-8815

32.8.2 SLMB, SLMB+, QDWI Backdating

Benefits can be backdated for up to three months prior to the month of application.  Use the backdating guidelines given in 2.8.2 Backdated Eligibility .

 

A person who would have been eligible as a QMB in the backdate period cannot receive backdated SLMBSpecified Low-Income Medicare Beneficiary , SLMB+, or QDWIQualified Disabled and Working Individual benefits.

 

 Example: Henry Schoolcraft applied for QMB on June 15, 1996.  He also requested backdated SLMB.  His income for June 1996 was under the QMB limit (100% of the federal poverty level).  He was determined eligible for QMB.  But his request for backdated SLMB was denied because his income, in the backdate months of March, April, and May, 1996, was under the QMB limit (100% of the FPLFederal Poverty Level).  

 

If he had applied for QMB in those months, he would have been QMB eligible.  Therefore, since he would have been QMB eligible in the backdate period, he cannot receive backdated SLMB benefits.

 

 

This page last updated in Release Number: 10-01

Release Date: 04-02-10

Effective Date: 04-02-10

The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030