400.05.04 MEDICARE COST-SHARING GROUP – QI (QUALIFYING INDIVIDUALS) COE-054

Section 4732 of the Balanced Budget Act of 1997 (P.L. 105-33) established 2 new mandatory eligibility groups of low-income Medicare beneficiaries called Qualifying Individuals or QI’s. Federal and state law implemented this provision effective January 1, 1998. The distinguishing factor of QI’s is a capped federal allotment for each state for the purpose of paying the Medicare Part B premiums (or partial premiums, as discussed for the QI-2 group below) for individuals who qualify. Enrollment in the QI-1 program may be stopped in any calendar year in which the aggregate amount of Part B benefits reaches the federal allotted amount. In addition, Congress must reauthorize the continuance of the QI-1 group each year since original legislation ended the program effective December 31, 2002.