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Medicaid Eligibility Manual Abbreviations/Acronyms/Definitions
Issued November 13, 2025 Page 14 of A-200 Replaces January 27, 2025
Revised/added text indicated by underscore Deleted text indicated by “**”
Protected Income – The $90.00 VA improved pension benefit that is received by certain single VA individuals residing in long-term care facilities.
Provider – An individual or group that provides medical services.
Provisional Medicaid – Provides coverage to individuals with disabilities or age 65 or older whose income is below the FBR and resources that meet the SSI limits.
Prudent Person – An individual who uses good judgment or common sense in handling practical matters. The prudent person concept shall be used by eligibility staff in administering the Medicaid program to determine the reasonableness of an action or decision based upon his or her knowledge of an experience with the Medicaid program. Eligibility staff must be prudent when the circumstances of a particular case indicate the need for further inquiry. Additional verification or substantiation should be obtained whenever the information provided by the applicant or beneficiary is incomplete, unclear, or contradictory.
Q
Qualified Medicare Beneficiary Only – An individual who is eligible for Medicaid payment only for Medicare Part A and/or B premiums, Medicare deductibles and Medicare co-insurance for Medicare covered services, not eligible for full Medicaid coverage. Formerly referred to as “pure QMB”.
Qualified Medicare Beneficiary Plus – An individual who is eligible for the same benefits as QMB Only and full benefit Medicaid in another program. Formerly referred to as “dual QMB.”
Qualified Non-Citizen – A non-citizen entering the U.S. on or after August 22, 1996, who is eligible only for emergency medical services until the residency requirement for consideration of full Medicaid coverage is met or unless they are not subject to the five (5) year bar.
Qualifying Individual – A Medicaid program whereby individuals are eligible for payment of Medicare Part B premiums.
R
Regular Renewal – A renewal by telephone, mail, or electronically submitted