1885.045.00 Participant Becomes Eligible for Medicare – DSS Manuals

IM-98 December 1, 2023

When a participant reports they are receiving Medicare, explore potential eligibility for a Medicare Savings Program (MSP).

MSPs help those qualified afford Medicare. There are four MSPs, each with different income and resource eligibility limits. These programs are:

Qualified Medicare Beneficiaries (QMB) (see 0865.000.00 Qualified Medicare Beneficiaries (QMB) )

Specified Low-Income Medicare Beneficiaries (SLMB1) (see 0870.000.00 Specified Low-Income Medicare Beneficiaries (SLMB1) and Qualifying Individuals (SLMB2) )

Qualifying Individuals (SLMB2) (see 0870.000.00 Specified Low-Income Medicare Beneficiaries (SLMB1) and Qualifying Individuals (SLMB2) )

Qualified Disabled Working Individual (QDWI) (see 0860.000.00 Qualified Disabled Working Individuals (QDWI) )

Automatically enroll MO HealthNet (MHN) participants in QMB and SLMB1 when it is determined they are eligible. A participant may choose to close QMB or SLMB1 coverage.

SLMB2 participants cannot receive MHN under any other type of assistance.

QDWI participants cannot be eligible for MHN under any other type of assistance.

Note: Adult Expansion Group (AEG) participants cannot be entitled to or enrolled in Medicare Part A or B.