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AX: N/A SR: N/A QM: A QI-1 is a Medicare beneficiary whose income is at least 120 percent of the FPL and less than 135 percent of the FPL and whose resources are no more than twice the SSI standard. The Medicaid program pays the Medicare Part B premium for a QI-1. (Note that effective July 1, 2005, there are no QI-1 eligible customers, since the QM and SLMB income limits have been increased to include these customers.)

QI-1 coverage begins the month of application. Additionally, QI-1s are eligible for the three-month retroactive eligibility determination.

There are no spend-down provisions for QI-1s.

QUALIFIED DISABLED AND WORKING INDIVIDUALS (QDWI) 1.14

AR: N/A AX: N/A SR: N/A QM: A QDWI is an individual who:

 lost his/her free Medicare Part A benefits due to his/her return to work,  is eligible to receive or receives Medicare Part A,  has income that does not exceed 200 percent of the FPL,  has assets that do not exceed twice the SSI limit, and  is not eligible for MA under any other category.

Benefits for QDWIs are limited to payment of Medicare Part A premiums only. Use the SR methodologies to determine income and resource eligibility. Eligibility as a QDWI is effective on the date all eligibility factors are met. Three-month retroactive eligibility is available to QDWIs. There are no spend-down provisions for QDWI eligibility.

If a customer appears to be eligible as a QDWI, please contact the Policy Unit for assistance in processing the case.

DISABLED INDIVIDUALS RETURNING TO WORK 1.15

AR: N/A AX: N/A Example Ms. Lindsay applies for benefits on October 1 and is enrolled in Medicare Part A. Her eligibility is effective October 1 (or up to 3 months retroactively if all eligibility criteria are met).