A-8300, Qualifying Individuals

Revision 14-2; Effective June 1, 2014

Persons eligible for this program do not receive regular Medicaid benefits. QIs must meet the eligibility criteria for the Qualified Medicare Beneficiary (QMB) Program, except the income limits are higher. Medicaid will pay the Medicare Part B premiums for QIs. These persons must be entitled to be enrolled in Medicare Part A and have countable income of at least 120 percent but less than 135 percent of the current federal poverty level. Eligibility is determined for each calendar year.QI recipients cannot be certified under any other Medicaid-funded program and receive QI benefits simultaneously (Public Law 105-33, Balanced Budget Act of 1997). For more information on the QI program, see Section Q-5000, Qualifying Individuals (QIs).

Automated System Program Identifier


Note: Even though ME-Pickle and ME-Disabled Adult Child (DAC) recipients may meet QI-1 eligibility requirements, the Medicare Part B premium is already paid by the state of Texas through the Pickle or DAC Medicaid program eligibility. The only requirement to test for QI-1 is if the Pickle or DAC eligibility will be denied.