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Title 8: Medicaid Page 96 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Non-MAGI-Related Coverage Groups Revised October 10, 2025 People in Medicare Savings Programs The effective date of assistance for this coverage group is either the first day of the month in which application is filed or an eligibility decision is made, whichever is earlier. Complete a review of eligibility factors for QDWP cases at a minimum of every 12 months. Complete a redetermination when changes are reported or made known. Terminate eligibility no later than the first of the month in which the client turns age 65 or when the person is no longer entitled to Part A Medicare.

Mr. V, age 36, files an application on April 13. The date of decision is April 25. The effective date of eligibility for QDWP is April 1. Qualified Medicare Beneficiaries (QMBs) Legal reference: P. L. 100-360, 441 IAC 75 (Rules in Process) People who are entitled to hospital insurance under Medicare Part A may be eligible for benefits through the “qualified Medicare beneficiary” (QMB) coverage group. Medicare refers to the QMB group as a “Medicare Savings Program.” People applying for QMB may refer to the coverage group as the Medicare Savings Program. Under QMB, Medicaid pays only for the person’s Medicare Part A and B premiums, coinsurance, and deductibles, unless the person is also concurrently eligible for full Medicaid benefits under another coverage group. NOTE: Persons are not eligible for QMB if they reside in an MHI and are over age 21 and under age 65. To be eligible for QMB, a person must meet all of the following requirements:  Is entitled to Medicare Part A.  Has net countable monthly income that does not exceed 100% of the federal poverty level by family size. (The standard is defined by the United States Office of Management and Budget and is revised annually in accordance with Section 673(2) of the Omnibus Budget Reconciliation Act of 1981.) To determine net countable monthly income, follow SSI policies. See 8-E, Income Policies for Non-MAGI-Related Coverage Groups. Allow the earned and unearned deductions. Consider the income prospectively.