Medicaid for the Elderly and People with Disabilities Handbook

Q-5000, Qualifying Individuals

Revision 24-3; Effective Sept. 1, 2024

The Qualifying Individuals (QIs) program pays only the Medicare premiums for people who meet all eligibility requirements.

QI has the same eligibility criteria as QMB except the person’s countable income must be at least 120% but less than 135% of the federal poverty level (FPL).

A person cannot be certified for any other Medicaid-funded program and the QI program at the same time. If eligible for both programs, the person must be given the opportunity to choose which benefit they prefer to receive. Document the person’s verbal or written choice in case comments, including the person’s choice between QI benefits and Community Attendant Services (CAS).

Related Policy

Medicare Savings Program Information, Appendix IX
Qualifying Individuals (QIs), A-8300
Medicare Savings Programs Overview, Q-1000
MSP Resource Limits, Q-1300
MSPs and Medicare Part B-ID, Q-1500
Qualified Medicare Beneficiaries, Q-2000
Medicare Savings Programs and Dual Eligibility, Q-4000

Q-5100, QI Benefits

Revision 09-4; Effective December 1, 2009

Authorized under 42 U.S.C. §1396a(a)(10)(E)(iv), the QI Program pays only Medicare Part B premiums to a person who is eligible for QI.

Q-5200, QI Income Limits

Revision 24-2; Effective June 1, 2024

Monthly income must be at least 120 percent FPL and less than 135 percent FPL.

Use the couple income limit when both spouses are applying for the same program.

Monthly Income Limits for the QI-1 Program

Time PeriodIndividual LimitCouple LimitDeeming*
March 1, 2024 to Present$1,506 to $1,695$2,044 to $2,300$605
March 1, 2023 to Feb. 29, 2024$1,458 to $1,640$1,972 to $2,219$579
March 1, 2022 to Feb. 28, 2023$1,359 to $1,529$1,831 to $2,060$531
March 1, 2021 to Feb. 28, 2022$1,288 to $1,449$1,742 to $1,960$511
March 1, 2020 to Feb. 28, 2021$1,276 to $1,436$1,724 to $1,940$504
March 1, 2019 to Feb. 29, 2020$1,249 to $1,406$1,691 to $1,903$497
March 1, 2018 to Feb. 28, 2019$1,214 to $1,366$1,646 to $1,852$486
March 1, 2017 to Feb. 28, 2018$1,206 to $1,357$1,624 to $1,827$470
March 1, 2016 to Feb. 28, 2017$1,188 to $1,337$1,602 to $1,803$466
March 1, 2015 to Feb. 29, 2016$1,177 to $1,325$1,593 to $1,793$468
March 1, 2014 to Feb. 28, 2015$1,167 to $1,313$1,573 to $1,770$457
March 1, 2013 to Feb. 28, 2014$1,149 to $1,293$1,551 to $1,745$452
March 1, 2012 to Feb. 28, 2013$1,117 to $1,257$1,513 to $1,703$446
March 1, 2011 to Feb. 29, 2012$1,089 to $1,226$1,471 to $1,655$429

*The deeming allocation amount is based on the difference between the couple and individual income limits.

Note: These amounts do not include the $20 disregard.

Related Policy

MSP Resource Limits, Q-1300
Budget Reference Chart, Appendix XXXI

Q-5300, Reserved for Future Use

Revision 20-3; Effective September 1, 2020

Q-5400, QI Medical Effective Date

Revision 09-4; Effective December 1, 2009

Eligibility for QI coverage is determined for each calendar year. A person's QI eligibility may begin with the month of application. A person with QI coverage is eligible for three months prior medical coverage if all criteria are met. The three-month prior period cannot extend back into the previous calendar year.

The application file date and prior coverage months must be in the same calendar year. Example: If the application is filed in February, the only possible prior coverage month is January.

Q-5500, Reserved for Future Use

Revision 12-2; Effective June 1, 2012

Q-5600, QI-2

Revision 12-2; Effective June 1, 2012

Authority for the QI-2 program under Public Law 105-33 expired on Dec. 31, 2002.