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North Carolina Department of Health and Human Services North Carolina Medicaid Division of Health Benefits AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2130

QUALIFIED MEDICARE BENEFICIARIES - Q

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REVISED 12/03/2018 – CHANGE NO. 06-18

Current Change Notice: 06-18 • The Qualified Medicare Beneficiaries policies have been revised in the online Adult Medicaid Manual in the following sections: MA-2130, Qualified Medicare Beneficiaries – Q

I. QUALIFIED MEDICARE BENEFICIARIES - Q

An applicant/beneficiary (a/b) who is enrolled in Medicare Part A and B, and has income at or less than 100% of poverty is eligible for the state to buy-in payment of the Medicare premiums, deductibles and coinsurance. Buy-in is effective the first day of the month after the month of disposition with “Q” Medicaid classification. No additional benefits are provided under this program. Medicaid card will be issued to beneficiaries authorized for MQB-Q. The beneficiary may meet the eligibility requirements for both MAABD and MQB-Q.

II. MQB-Q ELIGIBLITY REQUIREMENTS

A. Meet all Financial/Non-financial eligibility requirements.

B. Be Enrolled in Medicare Part A and B.

1. Refer to MA-2410, Medicare Enrollment and Buy-In, for an explanation of Medicare enrollment procedures.

2. MQB-Q beneficiary who is already enrolled in Medicare Part B will need to apply for Medicare Part A.

3. Verify Medicare coverage by seeing one of the following:

a. OVS

b. The Medicare card

c. BENDEX (Part B is SMI entitlement and Part A is HIB entitlement)

d. EOB - Explanation of Benefits

e. Note: Inmates of public institutions are not eligible for Medicare.

C. Income