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

 

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 Limit

Revision 21-2; Effective June 1, 2021

 

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
QI-1s Individuals
(income at least, but less than)
Couples
(income at least, but less than)
Deeming*
March 1, 2021 to Present $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. There must be at least a one cent unmet need for SLMB (MC-SLMB) eligibility.

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.