2675.1 Deemed Eligibles

Persons determined eligible for the following types of medical assistance are deemed eligible for the Medicare Part D subsidy without a separate application:

Title XIX (full Medicaid) under any program;

QMB, LMB or Expanded LMB; and

Medically Needy with a met spenddown.

An eligibility file is sent to CMS each month containing those individuals who meet the above criteria. The file is commonly known as the MMA file. Upon receipt of the monthly file, CMS confirms the individual is an eligible Medicare beneficiary and awards the subsidy. CMS will then communicate subsidy information to the Part D PDP.

NOTE : Persons receiving SSI benefits through Social Security, but not Medicaid, are also deemed eligible for the subsidy.