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SSI-Related Coverage Groups that Provide Limited Benefits - Medical Assistance - Iowa

Under the following programs, Medicaid pays part or all of the Medicare premiums for those who are eligible for Medicare and would be eligible for SSI and Medicaid except for financial eligibility criteria.

·        Qualified Disabled and Working Persons (QDWPs): Medicaid pays Part A premium for those who have disabilities, who are under age 65, who have worked 48 months, and have no other Medicare benefits, who have income less than 200% of the Poverty Guidelines, and who have less than twice the SSI resource limits.

·        Qualified Medicare Beneficiaries (QMBs): Medicaid pays Parts A and B premiums, as well as coinsurance and deductibles for those who are eligible for Part A, who have monthly incomes that do not exceed 100% of the Poverty Guidelines and who have less than twice the SSI resources limits.

·        Specified Low-Income Medicare Beneficiaries (SLMBs): Medicaid pays Medicare Part B premium for those who are eligible for Part A, who have monthly incomes that exceed 100% of the Poverty Guidelines but do not exceed 120% of those guidelines, and who have less than twice the SSI resources limits.

·        Expanded Specified Low-Income Medicare Beneficiaries: Medicaid pays Medicare Part B premium for those who are eligible for Part A, who have monthly incomes that exceed 120% of the Poverty Guidelines but do not exceed 135% of those guidelines, and who have less than twice the SSI resources limits.

·        Home Health Specified Low-Income Medicare Beneficiaries: Medicaid pays home health portion of Medicare Part B premium for those who are eligible for Part A, who have monthly incomes that exceed 135% of the Poverty Guidelines but do not exceed 175% of those guidelines, and who have less than twice the SSI resources limits.

See Also:

·           SSI-Related Coverage Groups

·           Overview of Medical Assistance in Iowa

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees’ Manual

Title 8 Medicaid

·                        Chapter F, Coverage Groups

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