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MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD MAABD Division of Welfare and Supportive Services B-310.3 Medical Assistance Manual MAABD MEDICAL CATEGORIES 25 Mar MTL 02/25 SPECIAL LOW-INCOME MEDICARE BENEFICARIES (SLMB) Note: If a SLMB eligible woman reports she is pregnant, evaluate Medicaid under the pregnant woman group. B-310.4 Qualified Individuals (QI) Covers only the Part B Medicare premium payment for aged and disabled individuals who: a. Are currently enrolled in or eligible to enroll in Medicare Part A; and b. Have net countable income 120% - 135% of FPL; and c. Have countable resources at or below $9,430 for individuals and $14,130 for married couples; and d. Are not eligible under any other Medicaid category Note: A Medicaid card is not issued for this program. This individual cannot be eligible for Medicaid under another category and be eligible as a qualified individual. Coverage begins with the application month, and prior medical coverage is available for up to three months prior to the application month. The Medicare premium is considered proof of service for prior medical requests. Note: If a QI eligible woman reports she is pregnant, evaluate Medicaid under the pregnant woman group. B-310.5 Qualified Disabled Working Individuals (QDWI) Covers ONLY special Medicare Part A hospital insurance premiums for disabled individuals who lose their free hospital coverage due solely to earnings which exceed the Substantial Gainful Activity (SGA) limits established by the Social Security Administration (SSA). These individuals must: a. Be under age 65; and b. Continue to meet Social Security's disability criteria; and c. Not be otherwise entitled to Medicare hospital coverage. Medicaid coverage of the Medicare hospital insurance premium is limited to individuals who: a. Have enrolled in the special Medicare hospital insurance at the SSA office; and b. Have net countable income below 200% of FPL; and c. Have countable resources which do not exceed $4,000 for individuals and $6,000 for married couples; and