210 R.I. Code R. § 210-RICR-40-05-1.6 - The Medicare Premium Payment Program (MPPP)
Persons seeking MPPP assistance are subject to the SSI-methodology for determining financial eligibility, though the income and resources standards specific to the MPPP coverage group, as indicated in § 1.6 of this Part, are applied. A disability determination is not required for MPPP financial help only. With the implementation of the State's IES, continuing eligibility is determined using a modified passive renewal process (See §00-2.7.2(A)(5) of this Chapter).
MPPP Eligibility Pathways |
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Coverage Group |
Full or Partial Eligible |
Income and Resource Limits Individual/Couple |
Benefits |
QMB |
Partial Dual |
100% FPL All MPPP applicants receive a $20.00 income disregard. $9,090.00 - Individual $13,630.00 - Couple |
Entitled to Medicare Part A and qualify for Medicaid payment of: Medicare Part A premiums (if needed) Medicare Part B premiums Certain premiums charged by Medicare Advantage plans Medicare deductibles, coinsurance, and copayments (except for nominal copayments in Part D, the Medicare drug program) |
QMB+ |
Full Dual |
100% FPL $4,000.00 / $6,000.00 |
All of the above AND Medicaid health coverage |
SLMB |
Partial Dual |
101% - 120% FPL $9,090.00 - Individual $13,630.00 - Couple |
Entitled to Medicare Part A and qualify for Medicaid payment of: Medicare Part B premiums |
SLMB + |
Full Dual |
101% - 120 % FPL $4,000.00 / $6,000.00 |
Same as above AND: Certain premiums charged by Medicare Advantage plans Medicare deductibles, coinsurance, and copayments (except for nominal copayments in Part D, the Medicare drug program) Full Medicaid Coverage |
QI |
Partial Dual |
121% - 135% FPL $9,090.00 - Individual $13,630.00 - Couple |
Entitled to Medicare Part A and qualify for Medicaid payment of: Medicare Part B premiums |
QWDI |
Partial Dual |
200% FPL $4,000.00 - Individual $6,000.00 - Couple |
Lost Medicare Part A benefits because of return to work but eligible to purchase Medicare Part A and qualify for Medicaid payment of: Medicare Part A premiums |
Notes
Amended effective
Amended effective
Amended effective
Amended effective
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
Persons seeking MPPP assistance are subject to the SSI-methodology for determining financial eligibility, though the income and resources standards specific to the MPPP coverage group, as indicated in § 1.6 of this Part, are applied. A disability determination is not required for MPPP financial help only. With the implementation of the State's IES, continuing eligibility is determined using a modified passive renewal process (See § 00-2.7.2(A)(5) of this Chapter).
MPPP Eligibility Pathways | |||
Coverage Group | Full or Partial Eligible | Income and Resource Limits Individual/Couple | Benefits |
QMB | Partial Dual | 100% FPL All MPPP applicants receive a $20.00 income disregard. $9,090.00 - Individual $13,630.00 - Couple | Entitled to Medicare Part A and qualify for Medicaid payment of: Medicare Part A premiums (if needed) Medicare Part B premiums Certain premiums charged by Medicare Advantage plans Medicare deductibles, coinsurance, and copayments (except for nominal copayments in Part D, the Medicare drug program) |
QMB+ | Full Dual | 100% FPL $4,000.00 / $6,000.00 | All of the above AND Medicaid health coverage |
SLMB | Partial Dual | 101% - 120% FPL $9,090.00 - Individual $13,630.00 - Couple | Entitled to Medicare Part A and qualify for Medicaid payment of: Medicare Part B premiums |
SLMB + | Full Dual | 101% - 120 % FPL $4,000.00 / $6,000.00 | Same as above AND: Certain premiums charged by Medicare Advantage plans Medicare deductibles, coinsurance, and copayments (except for nominal copayments in Part D, the Medicare drug program) Full Medicaid Coverage |
QI | Partial Dual | 121% - 135% FPL $9,090.00 - Individual $13,630.00 - Couple | Entitled to Medicare Part A and qualify for Medicaid payment of: Medicare Part B premiums |
QWDI | Partial Dual | 200% FPL $4,000.00 - Individual $6,000.00 - Couple | Lost Medicare Part A benefits because of return to work but eligible to purchase Medicare Part A and qualify for Medicaid payment of: Medicare Part A premiums |
Notes
Amended effective
Amended effective
Amended effective
Amended effective