Page 13
June 2021
P95/99—EMS P95—Not in ImpaCT P99—Impact
2540.45
HUSKY A Medically Needy Pregnant Women
• Covers pregnant women who would be eligible under Categorically Needy Pregnant Women Coverage (P01) except income or assets exceed AFDC limit Use MNIL asset limit and deeming rules which would apply in the month of the child(ren)’s birth
Financial eligibility is determined as if the child(ren) were born. Use FMA assistance unit composition rules as they would apply in the birth month Qualify every month in which they are pregnant and pass the medically needy financial eligibility tests Q01—EMS Q01—ImpaCT
2540.94
MSP Qualified Medicare Beneficiaries (CN)
• Must be entitled to Hospital Insurance under Medicare Part A • Have income within QMB limits
Special benefits for QMB is include: - Payment of Medicare A Premiums. - Payment of Medicare B Premiums. - Payment for co-insurance and deductible amounts for Medicare services
A QMB may be eligible for full Medicaid benefits under another coverage group during the same period QMB eligibility exists
Eligibility in Q-track coverage groups automatically qualifies individuals for the “Extra Help” program that coordinates with Medicare Part D prescription drug coverage
211% FPL
No asset test Qualifies the 1st of the calendar month following the month DSS has all verified information to establish eligibility as QMB, but no earlier than 1/1/89
Eligibility continues every month individual meets the coverage group criteria Q03—EMS Q03—ImpaCT
2540.95
MSP Specified Low Income Medicare Beneficiaries
• Payment of Medicare B premium only • A SLMB may be eligible for full Medicaid benefits under another coverage group the same period SLMB eligibility exists
Eligibility in Q-track coverage groups automatically qualifies individuals for the “Extra Help” program that coordinates with Medicare Part D prescription drug coverage
231% FPL
No asset test
Eligibility can begin 3 months prior to date of application, but no earlier than 1/1/93 Q04—EMS Q04—ImpaCT
2540.97
MSP Additional Low Income Medicare Beneficiaries Under 135% of Federal Poverty Level:
• Pays Medicare Part B premium only • Not an entitlement program - depends on funding • An ALMB is not eligible for full Medicaid benefits under another coverage group the same period ALMB eligibility exists
Eligibility in Q-track coverage groups automatically qualifies individuals for the “Extra Help” program that coordinates with Medicare Part D prescription drug coverage
246% FPL
No asset test