2672 Low Income Medicare Beneficiaries (LMB)

Persons who are entitled to Medicare benefits under Part A (including those entitled by reason of enrollment in the premium-paying Part A program) shall be eligible for coverage of Part B premiums only if:

Their countable income is no greater than 135% of the appropriate federal poverty level; and

Their countable resources do not exceed the allowable nonexempt resource level of 5130 (i.e., $7,390 or 1 person and $11,090 for 2 or more persons).

Although the LMB program is, in essence, an extension of the QMB program, except for the fact that benefits are limited to Part B premiums only, persons qualifying for QMB are not also eligible for LMB. These are two distinct programs and do not overlap. Persons whose income does not exceed 100% of the federal poverty level qualify only for QMB benefits (see 2671 ). For LMB, the eligible person's income would need to fall between 100% and 135% of poverty.

The general guidelines regarding Part A eligibility and financial eligibility for the QMB program as specified in and are applicable to LMB. This includes the separate determination of eligibility as well as the disregard of the Social Security cost-of-living adjustment in the first calendar quarter. A one-month base shall be applicable to LMB determinations in accordance with 7330 (1) . Total countable income to be considered in the eligibility base period shall be compared against the appropriate monthly poverty level standard (see F-8, Kansas Medical Standards ). Eligibility exists if the countable income does not exceed this level, and resources are within the allowable level.

Eligibility for LMB coverage shall be established only in the MA and Medically Needy programs. Coverage allows for immediate buy-in of Medicare Part B premiums. LMB benefits can be provided for the month of application, future months and the prior eligibility period. There is no delayed effective date as with QMB. There are two different groups of eligible individuals that exists within the program as indicated below.