Basic Considerations
To be eligible under this COA, an A/R must meet the following conditions:
The A/R is enrolled in Medicare Part A, Parts A and Part B, or Part B only.
The A/R meets all basic eligibility criteria. Since QI-1 recipients receive Medicare, they are exempt from the citizenship verification requirement. Citizenship was verified by SSA prior to awarding Medicare. The Declaration of Citizenship form is still required. Third Party assignment, Length of Stay (LOS) and Level of Care (LOC) are not requirements under this COA.
The A/R has countable resources of less than or equal to the current QMB/SLMB/QI-1 resource limit.
The A/R has countable net income of less than the QI-1 income limit but greater than the SLMB income limit.
QI-1 pays only the monthly premium for Part B Medicare for the QI1 eligible individual.
Retroactive coverage (three months prior) is allowed under this COA. QI-1 eligibility cannot pre-date January 1998.
The QI-1 income limit is based on the federal Poverty level (FPL). The FPL/QI-1 income limit is subject to change between February and April of each year. Therefore, the annual January RSDI COLAs are disregarded in determining QI-1 eligibility until the effective month of the new QI-1 income limit.
In-kind support and maintenance (ISM) is NOT considered in determining QI-1 eligibility.
THE STANDARD OF PROMPTNESS FOR PROCESSING A SLMB APPLICATION IS 10 WORKING DAYS FROM THE DATE OF RECEIPT OF THE APPLICATION.