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Title 8: Medicaid Page 93 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 Social Security Administration uses the following conditions to determine who qualifies to purchase Medicare Part A:  The person is under 65.  The person was previously entitled to extended Medicare benefits without a charge after social security disability benefits ended due to substantial gainful activity.  The person continues to have the same disabling condition that was the basis for receipt of social security disability benefits, or to be a disabled qualified railroad retirement beneficiary, or to be blind.  The person has worked continuously for 8 1/2 years (while receiving extended social security disability cash benefits for the first 9 months and then 7 years and 9 months of extended Medicare benefits after termination of social security disability cash benefits). (Determine that Medicare benefits stopped due to work.) NOTE: Before July 1997, the person would have received 9 months of social security disability benefits and then 36 months of extended Medicare benefits.  The person is not entitled to any other Medicare benefits. The Social Security Administration notifies the person that Medicaid payment for Medicare Part A may be an option at the same time it notifies the person that the person may continue Medicare Part A benefits by paying the premium. The Social Security Administration will inform the person of the general requirements for Medicaid eligibility and where to apply. Establish eligibility under the QDWP coverage group if:  The person is eligible for and enrolled in Part A Medicare. If the person chooses not to enroll, deny eligibility under this coverage group.  Resources do not exceed twice the maximum allowed by the SSI program. Resources are treated according to SSI policies. See 8-D, General Non-MAGI-Related Resource Policies. The resource limits for the QDWP group are $4,000 for an individual and $6,000 for a couple.  Net countable monthly income does not exceed 200% of the federal poverty level for the applicable family size.

Size of Family 200% of Poverty Level Individual $2,609 Couple $3,525