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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD B-310.2 MAABD MEDICAL CATEGORIES QUALIFIED MEDICARE BENEFICARIES (QMB) Division of Welfare and Supportive Services Medical Assistance Manual 25 Mar MTL 02/25 b. Have net countable income at or below 100% of FPL; and c. Have countable resources at or below $9,430 for individuals and $14,130 for married couples. Note: Individuals with QMB coverage receive a Medicaid card for billing Medicare co-pays and deductibles only. QMB coverage includes having their Part A and Part B premiums paid for by the Division, and payment for deductibles and co-insurance for services covered by Medicare but not normally covered by Medicaid. This category of assistance is different from all other categories. In addition to not receiving full Medicaid benefits: a. They do not have to pay patient liability if they are institutionalized, unless the case is converted to a state institutional case. b. They are eligible beginning the month immediately following the month the eligibility decision is made (they are not eligible for prior medical coverage). Note: If it is found QMB coverage was denied in error, use the denial decision date and approve benefits the month following this date. If QMB is terminated in error, reinstate coverage so there is no break in benefits. c. Individuals applying for QMB are not required to apply for benefits which may be available to them. Note: If a QMB eligible woman reports she is pregnant, evaluate Medicaid under the pregnant woman group. B-310.3 Special Low-Income Medicare Beneficiaries (SLMB) Covers only the Part B Medicare premium payment for aged and disabled individuals who: a. Are currently enrolled or eligible to enroll in Medicare Part A; and b. Have net countable income 100% - 120% of FPL; and c. Have countable resources at or below $9,430 for individuals and $14,130 for married couples. Note: SLMB does not pay for co-payments or deductibles. A Medicaid card will not be issued. Coverage begins with the application month, and prior medical coverage is available for up to three months prior to the application month to cover the Medicare premiums. The Medicare premium is considered proof of service for prior medical requests.