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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 July 2005 Subchapter Subject Page ending with Page M0310 GENERAL RULES & PROCEDURES M0310.121 33

• would be eligible for Social Security benefits if his governmental employment were covered work under the Social Security Act; OR b. is under age 65, disabled and • entitled to or deemed entitled to Social Security disability benefits for more than 24 months, • would be entitled to Social Security disability benefits for more than 24 months if his governmental employment were covered work under the Social Security Act, • under specified circumstances, entitled to Railroad Retirement benefits because of disability, • loses his entitlement to disability benefits and Medicare Part A solely because he is engaging in substantial gainful employment but voluntarily elects to enroll and pay a monthly premium; OR c. is any age and has end-stage renal disease treated by a kidney transplant or a regular course of kidney dialysis and meets the special insured status requirements. 2. Part B A person is eligible to enroll in Medicare Part B if he a. is entitled to premium-free Medicare Part A or pays a premium for Medicare Part A, OR b. is age 65 or older, a resident of the U.S., and either • a citizen of the U.S., or • an alien lawfully admitted for permanent residence who has resided in the U.S. continuously during the 5 years immediately prior to the month in which he or she applies for enrollment.

3. Part D A person is eligible to enroll in Medicare Part D if he: a. is entitled to Medicare Part A and/or enrolled in Medicare Part B; and b. is a resident of the United States. B. Procedures A Medicare beneficiary may be eligible for Medicaid if he meets all of the Medicaid eligibility requirements including any one or more of the covered groups. Four of the Medicaid covered groups are specifically for Medicare beneficiaries and provide a limited benefit package that pays costs related to Medicare, such as premiums, copays, and deductibles. These groups include Qualified Medicare Beneficiaries (QMBs), Special Low- income Medicare Beneficiaries (SLMBs), Qualified Disabled and Working Individuals (QDWIs) and Qualified Individuals (QI). QMBs, SLMBs, and QIs are also referred to as Medicare Savings Programs (MSP).