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2.General Information- 4MB

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Medicare Beneficiaries

Individuals eligible for Medicare may also qualify for benefits from the Medicare Beneficiaries program. Coverage provided by this program is different than other Medicaid groups as it does not provide the full scope of medical benefits. The categories described below may be eligible for Medicare Beneficiaries coverage:

 
  • Qualified Medicare Beneficiaries (QMBs) are Medicare recipients with income at or below 100% of the federal poverty level. Medicaid pays for their Medicare premiums, co-insurance and deductibles on Medicare covered services. Eligibility begins the month following the month the decision is made.
 
  • Special Low Income Medicare Beneficiaries (SLMBs) are Medicare recipients with income between 100% - 120% of the federal poverty level. Medicaid pays the Medicare Part B medical insurance premium. Eligibility begins with the application month with three (3) months of prior medical coverage available
 		 
 Pediatrician
  • Qualifying Individuals 1 (QI-1s) are Medicare recipients with income of at least 120%, but less than 135% of the federal poverty level. Medicaid pays the Medicare Part B medical insurance premium. Eligibility begins with the application month with three (3) months of prior medical coverage available. However, this program is 100% federally funded and ends if the state allocation is used.
 
  • Qualified Disabled Working Individuals (QDWIs) are Medicare recipients with income less than 200% of the federal poverty level. Medicaid pays the Medicare Part A hospital premium, only.