Ch. 18, § 11. Medicare Savings Programs

(a) Medicaid shall assist individuals eligible for the Qualified Medicare Beneficiary (QMB) program with paying their Medicare premiums, cost sharing and deductibles, as specified in Sections 1902(a)(10)(E)(i) and 1905(p)(1) of the Social Security Act. Individuals shall meet the following eligibility requirements: (i) Entitled to Medicare; (ii) Countable income shall be equal to or less than one hundred percent (100%) of the FPL; and, (iii) Countable resources shall not exceed the resource limit established by the SSA adjusted annually by the increase in the consumer price index. (b) Medicaid shall assist individuals eligible for the Specified Low-Income Medicare Beneficiary (SLMB) program with paying their Medicare Part B premium, as specified in Section 1902(a)(10)(E)(iii) of the Social Security Act. Individuals shall meet the following eligibility requirements: (i) Entitled to Medicare; (ii) Countable income shall be more than one hundred percent (100%) of the FPL but less than equal to one hundred twenty percent (120%) of the FPL. (iii) Countable resources shall not exceed the resource limit established by the SSA, adjusted annually by the increase in the consumer price index. (c) Medicaid shall assist individuals eligible for the Qualified Individual (QI) program with paying their Medicare premiums, as specified in Section 1902(a)(10)(E)(iv) of the Social Security Act. Individuals shall meet the following eligibility requirements: (i) Entitled to Medicare; (ii) Countable income shall be more than one hundred twenty percent (120%) of the FPL, but less than or equal to one hundred thirty-five percent (135%) of the FPL; and, (iii) Countable resources shall not exceed the resource limit established by the Social Security Administration adjusted annually by the increase in the consumer price index. (d) Medicaid shall assist individuals eligible for the Qualified Disabled Working Individual (QDWI) program with paying their Medicare Part A premiums, as specified in Section 1902(a)(10)(E)(ii) of the Social Security Act. Individuals shall meet the following eligibility requirements: (i) Be disabled according to Social Security guidelines, are ineligible for Social Security Disability Income (SSDI) and premium-free Medicare Part A benefits due to returning to work; (ii) Countable income shall be at or below two hundred percent (200%) of the FPL; (iii) Countable resources shall not exceed twice the limit of the SSI resource limit; and, (iv) Not otherwise eligible for another Medicaid program. (e) Eligibility shall be redetermined by the Department every twelve (12) months for all groups within this section. (f) Individuals shall be responsible for reporting to the Department any changes described in Section 4(c)(iii).