Q-5000, Qualifying Individuals (QIs)

Revision 21-2; Effective June 1, 2021

The Qualifying Individuals (QIs) program is an extension of QMB.

A person cannot be certified for any other Medicaid-funded program and the QI program at the same time. A person must be given the opportunity to choose which benefit they prefer to receive.

Because a person cannot receive both Medicaid and QI benefits at the same time, document their oral or written choice of preferred benefit in case comments, including the person’s choice between QI and Community Attendant Services (CAS) benefits.

Note: ME-Pickle and ME-Disabled Adult Child recipients cannot be dually eligible for QI as the Medicare Part B premium is already paid.

To be eligible for QI, a person must meet the eligibility criteria for QMB (see Section Q-2000), except the person must have an income that is greater than 120% but less than 135% of the federal poverty level.

Related Policy

Medicare Savings Program Information, Appendix IX
Qualifying Individuals (QIs), A-8300
Medicare Savings Programs Overview, Q-1000
MSP Resource Limits, Q-1300