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COMAR 10.09.24.03

352 State of Maryland Medical Assistance Manual Revised July 2012

Attachment A-2012 Dual Eligible Standards

2012 Dual Eligible Standards (Based on Percentage of Federal Poverty Level)

Qualified Medicare Beneficiary (QMB):

Monthly Income Limits: (100% FPL + $20)* All States and DC (Except Alaska & Hawaii): $ 951- Individual $1,281 – Couple Alaska: $1,185 – Individual $1,597 – Couple Hawaii: $1,092-Individual $1,471 – Couple

Asset Limits: $6,940-Individual $10,410 – Couple

Specified Low-Income Medicare Beneficiary (SLMB):

Monthly Income Limits: (120% FPL + $20)* All States and DC (Except Alaska & Hawaii): $1,137-Individual $1,533 – Couple Alaska: $1,417-Individual $1,912 – Couple Hawaii: $1,306-Individual $1,761 – Couple

Asset Limits: $6,940-Individual $10,410 – Couple

Qualifying Individual (QI):

Monthly Income Limits: (135% FPL + $20)* All States and DC (Except Alaska & Hawaii): $1,277 – Individual $1,723 – Couple Alaska: $1,592 – Individual $2,149 – Couple Hawaii $1,467 – Individual $1,979 – Couple

Asset Limits: $6,940 – Individual $10,410 – Couple

Qualified Disabled Working Individual (QDWI):

Monthly Income Limits: (200% FPL + $20)* (Includes additional earned income disregards)

All States and DC (Except Alaska & Hawaii): $3,809 – Individual $5,129 – Couple Alaska: $4,742 – Individual $6,392 – Couple Hawaii: $4,372 – Individual $5,889 – Couple Asset Limits: $4,000 – Individual $6,000 – Couple Includes: $20 = Amount of the Monthly SSI Income Disregard $1500= Burial Credit