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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 11 Effective Month: September 2023 Medicaid eligibility is based on SSI income and resource limits. The Division of Medicaid certifies eligibility for all the former SSI groups, as follows: • Cost of Living Individuals – these are former SSI recipients who become ineligible for SSI cash assistance because of a cost-of-living increase in title II benefits received after April 1977. These individuals must be granted Medicaid coverage if the sole reason for the loss of SSI was an increase in RSDI benefits received by the individual and/or his or her financially responsible spouse. • Disabled Adult Children – these are former SSI recipients age 18 or over whose disability onset date was prior to turning age 22. SSI must have been paid at any time after July 1987 and closed when title II benefits from a parent’s record began or increased, whichever caused the SSI to terminate. • Coverage is mandatory for certain disabled widows and widowers who would be eligible for SSI except for receipt of Social Security widow(er) benefits that terminated SSI. The individual must be age 50 through 64 and not eligible for Medicare to be evaluated for coverage under this provision.

Mandatory Coverage of Certain Medicare Cost-Sharing Groups The Division of Medicaid certifies eligibility for all the Medicare cost-sharing groups: • Qualified Medicare Beneficiaries (QMB) must be entitled to Medicare Part A and have income that does not exceed 100% of the federal poverty level. Medical assistance is limited to payment of Medicare cost-sharing expenses that includes premiums, co-insurance and deductible charges. Note: The only exception to the requirement of entitlement to Part A is made for individuals entitled to Medicare Part B-ID. Medicare Part B-ID, implemented January 2023 from the Consolidated Appropriations Act 2021, is solely for coverage of immunosuppressive drugs. Part B-ID may be awarded to individuals who lose Medicare entitlement based on end stage renal disease (ESRD) 36 months following a successful kidney transplant. Individuals are ineligible for Part B-ID if they have full Medicaid coverage that includes coverage for immunosuppressive drugs or other health insurance.