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can be identified as follows:

• Usually have only SSI income • Are age 65 or over; and • Have a HIB number ending in M, J3, J4, K3, or K4, and sometimes T. Also refer to Page VII-2 of the Medicaid Enrollment Manual Buy-In Section. No other verification of age is required, nor does the disability requirement applicable to the Medical Assistance for the Disabled category apply to individuals eligible as QMB only.

A QMB must also satisfy the citizenship, residency, SSN, and medical assignment requirements explained in the respective sections of this chapter. Refer to Section 3010.35.05 for QMB income standards and Section 3005.25.00 for QMB resource standards. QMB coverage is limited to payment of the following:73 • The monthly premium for Medicare Part B • The monthly premium for Premium Hospital Insurance under Medicare Part A, for individuals not entitled to free Part A o These premiums are required of certain persons entitled to hospital insurance benefits only by voluntary enrollment in the premium paying Part A program) • Medicare Part A and B deductibles and co-insurance. An individual can be simultaneously eligible under another full coverage category and QMB • Co-payments for Medicare Part C (Medicare Advantage plans).74 (Refer to Section 3465.05.00)

2416.10.00 QUALIFIED DISABLED AND WORKING INDIVIDUALS (MED 4) The policy in this section applies to the MA G category of assistance.

Disabled and working individuals who lost or will lose Medicare coverage because of their working status, are entitled to enroll in Medicare Part A under the provisions of the Omnibus Budget Reconciliation Act of 1989 (OBRA-89). If they also meet certain other eligibility requirements, they are eligible for the category of assistance entitled Qualified Disabled and Working Individuals (QDW).75

QDW coverage is limited to payment of the monthly premium for Medicare Part A only. These individuals may also enroll in Medicare Part B (if they are enrolled in Part A), but they will always be responsible for paying the Part B premium themselves. The individuals who contact the DFR and wish to apply for the QDW category of assistance should be asked to provide a notice from SSA informing them that they will lose their Medicare because of their working status. The affected Medicare beneficiary will receive such a notice in