Monday, July 22, 2013

Dual Eligible Medicare Beneficiary Groups by Benefits

1.    Qualified Medicare Beneficiaries Only*: Eligible for Medicaid payment of Medicare premium, deductible, coinsurance and copayment amounts (except for Medicare Part D).
2.    Qualified Medicare Beneficiaries Plus**: Entitled to all benefits available to a QMB, as well as all benefits available under the State Medicaid plan.
3.    Specified Low-Income Medicare Beneficiaries Only*: Eligible for payment of Medicare Part B premiums only.
4.    Specified Low-Income Medicare Beneficiaries Plus**: Entitled to all benefits available to an SLMB, as well as all benefits available under the State Medicaid plan.
5.    Qualifying Individuals: Eligible for payment of Medicare Part B premiums only; however, expenditures are 100% federally funded and total expenditures are limited by statute.
6.    Qualified Disabled Working Individuals: Eligible for Medicaid payment of Medicare Part A premiums only.
7.    Full Benefit Dual Eligibles: Eligible for Medicaid either categorically or through optional coverage groups.

Source: Centers for Medicare & Medicaid Services

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