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Title 8: Medicaid Page 103 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Non-MAGI-Related Coverage Groups Revised May 22, 2026 People in Medicare Savings Programs When a person is approved for an SSI or FIP cash grant, and is entitled to Medicare Part A, the person is eligible for QMB the following month. Because QMB provides only limited Medicaid coverage, the relationship between QMB and other coverage groups is complex, especially in two areas:  When a client is concurrently eligible for QMB and Medically Needy, the client is entitled only to QMB benefits until spenddown is met. Once spenddown is met, the client is entitled to all Medicaid benefits that are payable under Medically Needy.  When a QMB client is also eligible for full Medicaid benefits and is living in a skilled nursing facility, client participation is not charged until Medicare coverage is exhausted. See 8-I, Client Participation. Specified Low-Income Medicare Beneficiaries (SLMBs) Legal reference: 441 IAC 75 (Rules in Process) Limited Medicaid benefits are available to a person who meets all of these conditions:  Is entitled to Medicare Part A, which provides benefits for hospital care.  Has net countable monthly income that exceeds 100% of the federal poverty level for the family size but is less than 120% of this level.

For family size: Income is over: But is less than: Individual $1,305 $1,565 Couple $1,763 $2,115 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.  Has resources that do not exceed twice the maximum allowed by the SSI program. Resources are treated according to SSI policies. The resource limits for the SLMB group are $9,950 for an individual and $14,910 for a couple. See 8-D, General Non-MAGI-Related Resource Policies.  Meets all other nonfinancial non-MAGI-related Medicaid eligibility requirements except for disability determination and age. Medicaid will only pay the cost of the Medicare Part B premiums for these “specified low-income Medicare beneficiaries” (SLMBs). Medicare copayments, deductibles, and Part A are not covered for this coverage group.