1. Individuals who are enrolled in Medicare (Part A and/or B), have income that does not exceed 100% of the federal poverty level, and have resources no higher than twice the SSI resource limit are classified as categorically needy (Q). Refer to MA-2130, Qualified Medicare Beneficiaries-Q.
a. These individuals are eligible for payment of Medicare premiums and cost-sharing.
b. Classification code in EIS is “Q”.
2. Individuals can be dually eligible for MQB-Q and M-AABD when they meet the requirements for both programs.
B. MQB-B
1. Individuals who are enrolled in Medicare Part A, have income between 100% and 120% of the federal poverty level, and have resources no higher than twice the SSI resource limit are classified as categorically needy (B). Refer to MA-2140, Qualified Medicare Beneficiaries-B.
a. These individuals are eligible for payment of Medicare Part B premiums only.
b. Classification code in EIS is “B”.
2. Individuals can be dually eligible for MQB-B and M-AABD when they meet the requirements for both programs.
REISSUED 01/01/11 – CHANGE NO. 02-11
(II.)
C. M-WD - Qualified Disabled Working Individuals
1. Individuals who ceased receiving RSDI due to earnings, have income no higher than 200% of the federal poverty income level, and have resources no higher than twice the SSI resource limit are classified as categorically needy. However, since they are not entered in EIS, they have no classification code. Refer to MA-2150, Medicaid - Working Individuals.
2. These individuals are eligible for payment of Medicare Part A premiums only.
3. These individuals are not entered in EIS.
D. MQB-E (Qualifying Individuals - QI-1 Group)
1. Individuals who are enrolled in Medicare Part A, have income between 120% and 135% of the federal poverty level, and have resources no higher than twice the SSI resource limit are classified as categorically needy (E). Refer to MA-2160, Qualifying Individuals –1.
a. These individuals are eligible for payment of Medicare Part B premiums only.
b. Classification code in EIS is “E.”
2. MQB-E is a capped entitlement.
3. Qualifying Individuals cannot be eligible for Medicaid in any other category, and they cannot be dually eligible.
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.
