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COMAR 10.09.24.03
338 State of Maryland Medical Assistance Manual Revised July 2012 Retroactive coverage does not apply; Spend-down does not apply; and A higher income and resource standard.
The effective date of the Buy-in coverage is January 1, 1989. Scheduled redeterminations are required at 12-month intervals. Eligible persons will be issued a gray and white QMB identification card. A QMB eligible person or couple whose resources are within Schedule MA- 2, but whose income exceeds Schedule MA-1 may also qualify for regular MA under spend- down. Refer to section K and L of this part for complete procedures. If a Buy-in recipient meets MA spend-down eligibility, the case status changes from QMB Buy-in only to MA and Buy-in coverage (dual eligibility).
Nothing in this section changes the eligibility determination methodology of a Medicare Beneficiary who is ineligible for the Buy-in.
Applicable Regulations
Since the majority of Medicare beneficiaries are aged (65 years old or older), the ABD rules will generally apply to the eligibility determination. A smaller number of beneficiaries are disabled, some of whom are the parents of minor children who live in the home.
Application
A completed DHR/FIA 9705 application form by mail QMB applications can be used when applying for QMB/SLB (Specified Low income Medicare Beneficiaries)
The procedures in COMAR 10.09.24.04 are applicable. The application form DHR/FIA 9705 is the instrument by which eligibility information is collected. Unless specifically stated otherwise, the filing of an application form represents an application for both MA and the QMB Buy-in only coverage. In the case of a Medicare beneficiary request to apply for the Buy-in only coverage, that request may be honored and the local department is not required to determine MA eligibility for other family members.
Consistent with COMAR 10.09.24.04, which allows an applicant to decide the category in which he/she wants eligibility established, a blind or disabled Medicare beneficiary who is a parent may be included in an FAC unit with his/her children and spouse if he/she is to do so.
QMB Eligibility Criteria