Effective Date: May 1, 2006

Contact DHHS Policy Specialist for Previous Policy

SSA allows some disabled people to keep Part A Medicare, by paying the premium. The member must be eligible for Part A Medicare under Section 1818A of the Social Security Act. A person eligible for Medicare Part A under Section 1818A is a person who:

Is disabled and under age 65, and

Was entitled to Medicare Part A because the person was entitled, for 24 calendar months, to Social Security Disability benefits, Child’s insurance benefits because of disability, Widows benefits because of disability, or disabled railroad retirement payments, but

Lost that entitlement only because of earnings that exceeded the substantial gainful activity amount, and

Is not otherwise entitled to Medicare Part A.

Benefits

QDWI pays the Part A premium.

TPL

TPL process is not required.

QDWI and Other Medicaid Programs

The member doesn’t qualify for QDWI:

If the member qualifies for Medicaid without a spenddown.

If the member qualifies for spenddown Medicaid or MWI and pays the spenddown or MWI premium.