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Chapter: 0200 General Program Information Program: MSSI, SFP 12 0240.0114 Working Disabled (MSSI) Most individuals with disabilities who work will continue to receive at least 93 consecutive months of hospital (Part A) and medical (Part B) insurance under Medicare. They pay no premium for Part A. After premium-free Medicare Part A coverage ends, they can continue receiving Medicare Part A, but must pay a premium, as long as they remain medically disabled and continue to work.

This program provides payment of the Medicare Part A premium for individuals who apply and meet the following criteria:

1. Are enrolled in Medicare Part A under this special extended coverage (as confirmed by SSA). 2. Are under age 65. 3. Meet all other technical criteria. 4. Income: 200% of Federal Poverty Level. 5. Assets: $5000 (Individual), $6000 (Couple).

Note: These individuals cannot receive any Medicaid service other than payment of the Medicare Part A premium. 0240.0115 Special Low Income Medicare Beneficiary (MSSI) This program entitles eligible individuals who have to have Medicaid pay their Part B Medicare premium.

To be eligible for SLMB, an individual must:

1. Be enrolled in Medicare Part A. 2. Meet all technical criteria, except being aged (65 or older requirement) or disabled. 3. Income Limit: 120% of Federal Poverty Level. 4. Asset Limit: Three times the SSI resource limit with annual increases based on the yearly Consumer Price Index. Refer to Appendix A-9. 0240.0116 Qualifying Individuals 1 (MSSI) This program allows eligible individuals to have Medicaid pay the Medicare Part B premiums. This is a program with limited funding. It is available on a first-come, first-serve basis.

To be eligible for QI1, an individual must:

1. Be enrolled in Medicare Part A. 2. Meet all technical criteria, except being aged (65 or older requirement) or disabled. 3. Income Limit: 135% of Federal Poverty Level. 4. Asset Limit: Three times the SSI resource limit with annual increases based on the yearly Consumer Price Index. Refer to Appendix A-9. 0240.0117 Program for All Inclusive Care for the Elderly (MSSI) Program of All-Inclusive Care for the Elderly (PACE) is an optional Medicaid benefit available only in participating areas. PACE is designed to serve the frail elderly in the home and community. This program offers comprehensive services that include acute and long-term care. For most participants, the comprehensive service package permits them to continue living at home while receiving services rather than being institutionalized.

To be eligible for PACE:

1. the individual must be at least 55 years of age and meet all other technical criteria, 2. income must not exceed 300% of the SSI Federal Benefit Rate, and