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BEM 169 1 of 4 QUALIFIED DISABLED WORKING INDIVIDUALS BPB 2016-006 4-1-2016

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

DEPARTMENT POLICY MA Only This is an SSI-related MA category. It is neither a Group 1 nor a Group 2 MA category. MA pays only the recipient's Medicare Part A premium. A person eligible under this category is called a Qualified Disabled Working Individual (QDWI). A QDWI is a person who:  Receives, or is eligible to enroll in, Medicare Part A under section 1818A of the Social Security Act, and  Is not eligible for MA under any other category, and  Meets the eligibility factors specified in this item. All eligibility factors must be met in the calendar month being tested. BEM 546, Post-Eligibility Patient-Pay Amounts, does not apply. INQUIRY A person may wish to know whether MA will pay Medicare Part A premiums before enrolling. If the person is not an MA, FIP or SSI recipient, do a determination of QDWI eligibility. Advise the person whether he might be eligible. In doing this determination:  Explain the nonfinancial eligibility factors. Assume they will be met.  Determine financial eligibility using current information. Verification is not required.  Explain that changes may affect the actual determination of eligibility. Be sure to discuss asset policies thoroughly if the person's current assets exceed the limit. NONFINANCIAL ELIGIBILITY FACTORS 1. The person must receive or be eligible to enroll in Medicare Part A under section 1818A of the Social Security Act (Act). See "1818A Identification" below.

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Official source

BEM 169 1 of 4 QUALIFIED DISABLED WORKING INDIVIDUALS BPB 2016-006 4-1-2016

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

DEPARTMENT POLICY MA Only This is an SSI-related MA category. It is neither a Group 1 nor a Group 2 MA category. MA pays only the recipient's Medicare Part A premium. A person eligible under this category is called a Qualified Disabled Working Individual (QDWI). A QDWI is a person who:  Receives, or is eligible to enroll in, Medicare Part A under section 1818A of the Social Security Act, and  Is not eligible for MA under any other category, and  Meets the eligibility factors specified in this item. All eligibility factors must be met in the calendar month being tested. BEM 546, Post-Eligibility Patient-Pay Amounts, does not apply. INQUIRY A person may wish to know whether MA will pay Medicare Part A premiums before enrolling. If the person is not an MA, FIP or SSI recipient, do a determination of QDWI eligibility. Advise the person whether he might be eligible. In doing this determination:  Explain the nonfinancial eligibility factors. Assume they will be met.  Determine financial eligibility using current information. Verification is not required.  Explain that changes may affect the actual determination of eligibility. Be sure to discuss asset policies thoroughly if the person's current assets exceed the limit. NONFINANCIAL ELIGIBILITY FACTORS 1. The person must receive or be eligible to enroll in Medicare Part A under section 1818A of the Social Security Act (Act). See "1818A Identification" below.