Ill. Admin. Code tit. 89, § 120.73 - Eligibility for Payment of Medicare Part B Premiums for Specified Low-Income Medicare Beneficiaries (SLIBs) and Qualified Individiduals-1 (QI-1)
a) To the extent
permitted under federal law (
42 USC
1396 a(a)(10) ), eligibility for payment of
Medicare Part B premiums exists for Specified Low-Income Medicare Beneficiaries
(SLIBs) and Qualified Individuals-1 (QI-1).
b) A SLIB is an individual who:
1) is a beneficiary of Medicare Part A (i.e.,
Hospital Insurance);
2) meets the
general non-financial factors of eligibility for the Medicaid Program (see
Sections
120.310,
120.311,
120.319
and
120.325
);
3) has countable monthly income
greater than 100 percent of the Federal Poverty Level (FPL), but less than 120
percent of the FPL; and
4) has
countable assets that do not exceed the QMB asset disregard (see Section
120.382(f)(1)
).
c) A QI-1 is an individual who:
1) is a beneficiary of Medicare Part A (i.e.,
Hospital Insurance);
2) meets the
general non-financial factors of eligibility for the Medicaid Program (see
Sections 120.310, 120.311, 120.319 and 120.325);
3) has countable monthly income that is at
least 120 percent of the FPL, but less than 135 percent of the FPL;
4) has countable assets that do not exceed
the QMB asset disregard (see Section
120.382(f)(1)
);
5) is not otherwise eligible for medical
assistance; and
6) has been
selected as a qualifying individual as provided under
42
USC 1396u-3.
d) In determining countable monthly income,
the monthly amount of Social Security benefits to consider for January through
the month following the month in which the annual FPL amounts are announced
will not include the annual Retirement Survivors Disability Insurance (RSDI)
Cost of Living Adjustment (COLA). For all other months of the year, the full
amount of RSDI benefits will be considered.
e) Eligibility for payment of Medicare Part B
premiums may be effective up to three months prior to the month of
application.
f) Eligibility for
SLIB status will be redetermined at least every 12 months.
Notes
Amended at 36 Ill. Reg. 4133, effective March 1, 2012
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