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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

153 8. For the purpose of identifying the proper SISC code for persons receiving assistance under OAP “A” or OAP “B”, if the person: a. receives an SSI payment (SISC B); b. does not receive an SSI payment but is receiving assistance under OAP “A”, a second evaluation of resources must be made using the same resource criteria as specified in section 8.100.5.M for those who meet this criteria the SISC code is B for money payment and “disregard” case, A for institutional cases; c. does not receive an SSI payment and does not otherwise qualify under SISC code B or A as described in item b. above (SISC C). 8.100.6.L. Qualified Medicare Beneficiaries (QMB) 1. Medical Assistance coverage for QMB members is payment of Medicare part B premiums, co-insurance and deductibles. 2. In order to be eligible as a Qualified Medicare Beneficiary, the individual must meet the following: a. is entitled to Part A Medicare; and b. resources may not exceed the standard for an individual or couple who have resources, as described in section 8.100.5.M; and c. has income at or below the percentage of the federal poverty level for the size family as mandated for QMB by federal regulations. Poverty level is established by the Executive Office of Management and Budget. d. is enrolled in the mandatory SSI program with premium-free Medicare Part A. 3. For QMB purposes, couples shall have their income compared against the federal poverty level couples income maximum. This procedure shall be applied whether one or both members apply for QMB. 4. For QMB purposes, income of the applicant and/or the spouse shall be determined as described under Income Requirements in section 8.100.5. If two