23 Miss. Code. R. 100-8.9 - Mandatory Coverage of Certain Medicare Cost-Sharing Groups

A. Qualified Medicare Beneficiaries (QMB) must be entitled to Medicare Part A and have income that does not exceed one hundred percent (100%) of the federal poverty level. Medical assistance is limited to payment of Medicare cost-sharing expenses that includes premiums, co-insurance and deductible charges.

B. Specified Low-Income Medicare Beneficiaries (SLMB) must be entitled to Medicare Part A and have income greater than one hundred percent (100%) of the federal poverty level but less than one hundred twenty percent (120%) of the federal poverty level. Medical assistance for this group is limited to payment of Medicare Part B premiums.

C. Qualifying Individuals (QI) must be entitled to Medicare Part A and have income that is at least one hundred twenty percent (120%) of the federal poverty level but less than one hundred thirty-five percent (135%) of the federal poverty level. Medical assistance for this group is limited to payment of Medicare Part B premiums under a federal allotment of funds. Eligibility for coverage as a QI is dependent on the availability of federal funds.

D. Qualified Disabled and Working Individuals must be entitled to Medicare Part A and have income that does not exceed two hundred percent (200%) of the federal poverty level whose return to work results in the loss of coverage for Medicare. Medical assistance is limited to payment of the Part A premium.

E. The Division of Medicaid certifies eligibility for all of the Medicare cost-sharing groups.

Notes

23 Miss. Code. R. 100-8.9

42USC §§ 1395w-114, 1396 a, 1396d.

Amended 4/1/2016