32.8 Medicare Savings Programs Backdating

32.8.1 QMB Backdating

Occasionally, the benefits of a person who is eligible for QMB do not correctly begin on the first of the following month. This can occur if:

The eligibility process was not completed within 30 days.
Certification of eligibility was not completed.
A fair hearing decision has ordered backdated QMB benefits.

If eligibility for QMB should start prior to the month after the confirmation month, complete a Medicaid/BadgerCare Plus Eligibility Certification form (F-10110) (formerly DES 3070) and fax it to 608-221-8815 or mail it to:

ForwardHealth

Eligibility Unit

P.O. Box 7636

Madison, WI 53707

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 in Section 2.8.2 Backdated Eligibility.

A person cannot receive backdated SLMB , SLMB+ , or QDWI benefits for months in which he or she would have been eligible for QMB.

Example 1: Henry applied for MSP on June 15. He also requested a three-month backdate. His income for June was under the QMB income limit (100% of the FPL). He was determined eligible for QMB for ongoing months. His backdated eligibility was denied because his income in each of the backdated months of March, April, and May was under the QMB income limit (100% of the FPL). Since he would have been QMB eligible in the backdate period, he cannot receive backdated SLMB or SLMB+ benefits.

This page last updated in Release Number: 17-03

Release Date: 11/03/2017

Effective Date: 08/05/2017

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