Why are the reasons for Medicaid eligibility denials not clearly spelled out by DSS?
The form letter DSS sent to the constituent indicates that she is over income for Medicaid eligibility by about $ 200 per month. (This spend-down amount is derived by comparing her monthly Social Security disability benefit ($ 942), with the Medicaid income limit (about $ 715 per month)). In order to qualify for benefits, the constituent must provide DSS with documentation (e. g. , medical bills) that she has excess medical expenses totaling at least $ 1,333. 68. The letter did not go into how DSS calculated eligibility. According to the constituent’s caseworker, DSS’ central office generates the letter. 4. Who pays the constituent’s monthly Medicare premiums, the state or federal government? What is the current monthly Part B premium? Although she appears to be ineligible for full Medicaid coverage for the current six-month period, the DSS letter indicates that the constituent still qualifies for the Qualified Medicare Beneficiary (QMB) program. This is one of several Medicaid-funded
