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Medicaid Program - Qualifying Individuals Program - Oklahoma

The Qualifying Individual (QI) program is available to individuals who are enrolled for Medicare hospital insurance benefits under Part A, including those who have voluntarily enrolled in the premium-paying Part A program.

The maximum income standard for the QI-1 program is an amount greater than 120% but less than 135% of the Federal Poverty Level. The maximum income standard for the QI-2 program is an amount between 135% and less than 175% of the Federal Poverty Level.

For an individual whose spouse is not eligible for Medicare, total countable income of the eligible individual must be equal to or less than the QI standards for an individual and the income of both must be equal to or less than the QI standards for a couple.

Countable income and resources are determined using the same rules followed in determining eligibility for individuals categorically related to aid to the aged, blind, or disabled, with the following exceptions:

·             Payments from Champus for medical care or from VA for Aid and Attendance are not considered in determining income eligibility

·             A $20 general income disregard is also applied to either earned or unearned income, but not both. For couples, only one $20 general income disregard is given.

A Qualifying Individual cannot be otherwise eligible for Medicaid. Unlike Qualified Medicare Beneficiary (QMB) or Specified Low Income Medicare Beneficiary (SLMB) individuals, who may be determined eligible for Medicaid benefits in addition to their QMB/SLMB benefits, a QI recipient is not eligible to receive any other type of Medicaid benefit.

See Oklahoma DHS Appendix C-1 for income and resource limits. In the appendix, Schedule VII.A contains information about QI-1, and Schedule VII.B has information about QI-2.

See also:

Medicaid Program - Eligibility - Oklahoma

Medicaid Program - Medicare Expenses - Oklahoma

Medicaid Program - Countable Income - Oklahoma

Medicaid Program - Income Disregards - Oklahoma

Medicaid Program - Resource Limits - Oklahoma

Medicaid Program - Overview - Oklahoma

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