Or. Admin. Code § 461-155-0295 - Income Standard; QMB-SMB, QMB-SMF

(1) Eligibility for Qualified Medicare Beneficiaries - Specified Low Income Medicare Beneficiary (QMB-SMB) requires income greater than 100 percent (see OAR 461-155-0290) but less than 120 percent of the federal poverty level. The adjusted income standard for QMB-SMB is 120 percent of the 2025 federal poverty level.

QMB-SMB Adjusted Income Standard (Case Descriptor SMB)

No. in Need Group ..............................	Amount
1 . ...........................................................	$1,565
2 . ...........................................................	2,115
3 . ...........................................................	2,665
4 . ...........................................................	3,215
5 . ...........................................................	3,765
6 . ...........................................................	4,315
7 . ...........................................................	4,865
8 . ...........................................................	5,415
9 . ...........................................................	5,965
10 . .........................................................	6,515
Each additional person .......................	+ 550

(2) Eligibility for Qualified Medicare Beneficiaries - Supplemental Medicare Full (QMB-SMF) requires income equal to or greater than 120 percent (see section (1) of this rule) but less than 135 percent of the federal poverty level. The adjusted income standard for QMB-SMF is 135 percent of the 2025 federal poverty level.

QMB-SMF Adjusted Income Standard (Case Descriptor SMF)

No. in Need Group ..............................	Amount
1 . ...........................................................	$1,761
2 . ...........................................................	2,380
3 . ...........................................................	2,999
4 . ...........................................................	3,617
5 . ...........................................................	4,236
6 . ..........................................................	4,855
7 . ...........................................................	5,474
8 . ...........................................................	6,092
9 . ...........................................................	6,711
10 . .........................................................	7,330
Each additional person .......................	+ 619

Notes

Or. Admin. Code § 461-155-0295

AFS 35-1992, f. 12-31-92, cert. ef. 1-1-93; AFS 5-1993, f. & cert. ef. 4-1-93; AFS 6-1994, f. & cert. ef. 4-1-94; AFS 29-1994, f. 12-29-94, cert. ef. 1-1-95; AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95; AFS 16-1996, f. 4-29-96, cert. ef. 5-1-96; AFS 5-1997, f. 4-30-97, cert. ef. 5-1-97; AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98; AFS 6-1998(Temp), f. 3-30-98, cert. ef. 4-1-98 thru 5-31-98; AFS 8-1998, f. 4-28-98, cert. ef. 5-1-98; AFS 3-1999, f. 3-31-99, cert. ef. 4-1-99; AFS 10-2000, f. 3-31-00, cert. ef. 4-1-00; AFS 6-2001, f. 3-30-01, cert. ef. 4-1-01; AFS 5-2002, f. & cert. ef. 4-1-02; AFS 19-2002(Temp), f. 12-10-02, cert. ef. 1-1-03 thru 5-31-03; AFS 22-2002, f. 12-31-02, cert. ef. 1-1-03; SSP 7-2003, f. & cert. ef. 4-1-03; SSP 8-2004, f. & cert. ef. 4-1-04; SSP 4-2005, f. & cert. ef. 4-1-05; SSP 4-2006, f. & cert. ef. 3-1-06; SSP 2-2007(Temp), f.& cert. ef. 3-1-07 thru 3-31-07; SSP 4-2007, f. 3-30-07, cert. ef. 4-1-07; SSP 6-2008(Temp), f. 2-29-08, cert. ef. 3-1-08 thru 8-28-08; SSP 8-2008, f. & cert. ef. 4-1-08; SSP 23-2008, f. & cert. ef. 10-1-08; SSP 26-2008, f. 12-31-08, cert. ef. 1-1-09; SSP 6-2009(Temp), f. & cert. ef. 4-1-09 thru 9-28-09; SSP 13-2009, f. & cert. ef. 7-1-09; SSP 8-2011(Temp), f. & cert. ef. 3-1-11 thru 8-28-11; SSP 17-2011, f. & cert. ef. 7-1-11; SSP 8-2012, f. & cert. ef. 3-1-12; SSP 6-2013, f. & cert. ef. 3-1-13; SSP 4-2014(Temp), f. 2-4-14, cert. ef. 3-1-14 thru 8-28-14; SSP 7-2014, f. & cert. ef. 3-7-14; SSP 8-2015, f. 2-27-15, cert. ef. 3/1/2015; SSP 8-2016, f. 2-18-16, cert. ef. 3/1/2016; SSP 5-2017, f. & cert. ef. 3/1/2017; SSP 8-2018, amend filed 02/15/2018, effective 3/1/2018; SSP 3-2019, amend filed 02/07/2019, effective 3/1/2019; SSP 2-2020, amend filed 02/24/2020, effective 3/1/2020; SSP 3-2021, amend filed 02/11/2021, effective 3/1/2021; SSP 29-2022, amend filed 02/24/2022, effective 3/1/2022; SSP 8-2023, amend filed 01/30/2023, effective 3/1/2023; SSP 15-2024, amend filed 02/27/2024, effective 3/1/2024; SSP 1-2025, amend filed 02/20/2025, effective 3/1/2025

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Statutory/Other Authority: ORS 411.060, 411.070, ORS 409.050, 413.085 & 414.685

Statutes/Other Implemented: ORS 411.060, 411.070, ORS 409.010 & 42 USC 1396a(10)(E)(iii)-(iv)