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DE Medicaid - Medicare Related Medicaid

The four groups in this category are actually a special subset of the SSI-Related Covered Groups. These four groups have three characteristics in common: 1) They are for people who receive Medicare; 2) Income-eligibility is related to the Federal Poverty Level (FPL); and the benefits are very limited.

There are no longer any resource limits for these covered groups.

Qualified Medicare Beneficiaries (QMB): Delaware Medicaid pays Medicare Part A and Part B premiums, co-insurance and deductible expenses for Medicare beneficiaries with incomes that do not exceed 100% of the Federal Poverty Level (FPL). QMB recipients do not receive any other Medicaid services.

NOTE: Income limits discussed above for QMBs become effective April 1, 2007 for use of the 2007 Federal Poverty Level guidelines. The 2007 SSI Cost Of Living Adjustment (COLA) is disregarded until April 1, 2007.

Specified Low Income Medicare Beneficiaries (SLMB): Medicaid pays the Medicare Part B premium for these individuals who have income that does not exceed 120% FPL. SLMB recipients do not receive any other Medicaid services.

NOTE: Income limits discussed above for SLMBs become effective April 1, 2007 for use of the 2007 Federal Poverty Level guidelines. The 2007 SSI Cost Of Living Adjustment (COLA) is disregarded until April 1, 2007.

Qualified Disabled And Working Individuals (QDWI): These are disabled individuals who lose premium-free Part A Medicare benefits due to employment. Medicaid will pay the Part A premiums for these individuals who have income at or below 200% FPL. QDWI recipients do not receive any other Medicaid services.

NOTE: Income limits discussed above for QDWIs became effective January 1, 2007 for use of the 2007 Federal Poverty Level guidelines.

Qualifying Individuals (QI-1): QI-1s must have income between 120% and 135% FPL and are eligible to have their Part B premiums paid by Medicaid. Qualifying Individuals do not receive any other Medicaid services.

NOTE: Income limits discussed above for QI-1s become effective April 1, 2007 for use of the 2006 Federal Poverty Level guidelines. The 2007 SSI Cost Of Living Adjustment (COLA) is disregarded until April 1, 2007.

See also:

DE Medicaid - Income Eligibility for Medicare Related Medicaid

DE Medicaid - Eligibility

DE Medicaid - Application Procedures

DE DSS - Change Reporting Requirements

DE DSS - Contact Information

Source:

DSS Policy Manual (Sects. 17300, 400, 500 & 700)

Administrative Notice DMMA-02-2006, January 27, 2006

Back to:

DE Medicaid - Covered Groups

DE Medicaid - Overview

DE Division of Social Services - Overview

DE Benefit Information System Overview

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