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AGED, BLIND, AND DISABLED MEDICAID 201-8 Medicare Savings Programs

Supersedes: ABD 201-8 (7/1/2024) Reference: ARM 37.82.101, ARM 37.83.201, .202, P.L. 105-33, P.L. 110-275; P.L. 100- 360 (1988), P.L. 101-239 § 6411 (1989), and P.L. 101-508 § 4501 (1990); 42 U.S.C. 1396d (p) Overview: Qualifying Medicare beneficiaries may be eligible for additional coverage to help with Medicare-related expenses. There are three Medicare Savings Programs (MSP): 1. Qualified Medicare Beneficiaries (QMB); 2. Specified Low-Income Medicare Beneficiaries (SLMB); 3. Qualifying Individual (QI). Clients may be eligible for QMB or SLMB coverage in addition to categorically or medically needy (“regular”) Medicaid coverage. When the OPA is notified (via interface or client report) that a current Medicaid client is entitled to Medicare Part A or Part B, MSP eligibility must be evaluated. MEDICARE ENTITLEMENT: Unless refused, Medicare Part A and B enrollment is automatic for most Medicare beneficiaries. MSP coverage cannot be denied for an otherwise-eligible client simply because they are not enrolled in Medicare Part A and/or Part B. Medicare coverage (entitlement) always begins on the first day of the coverage month. MEDICARE ENROLLMENT PERIOD: There are two enrollment periods for Medicare A & B entitlement: 1. The initial enrollment period, which includes the: a. Three months prior to an individual’s 65th birthday or 25th month of disability benefits receipt; b. Month of the 65th birthday or 25th month of disability benefits receipt; and