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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 July 2022 Subchapter Subject Page ending with Page M0310 GENERAL RULES & PROCEDURES M0310.128 37
B. Procedure QDWI is a mandatory covered group that the state plan must cover for the purpose of paying the beneficiary’s Medicare Part A premium. See section M0320.604 for the procedures to use to determine if an individual meets the QDWI covered group.
M0310.126 Qualified Individuals
A. Qualified Individuals (QI)
QI is the short name used to designate the Medicaid covered group of “Qualified Individuals.” A qualified individual means a Medicare beneficiary • who is entitled to Medicare Part A, • who has resources that are within the resource limits for the Medicare Savings Programs (MSPs). See chapter section M1110.003 for the current resource limits; and
• whose income is equal to or more than 120% of the federal poverty level (FPL) and is less than 135% FPL. B. Procedure QI is a mandatory covered group that the State Plan must cover for the purpose of paying the Medicare Part B premium for the QI. See section M0320.603 for the procedures used to determine if an individual meets the QI covered group.
M0310.127 QMB
A. Qualified Medicare Beneficiary (QMB) QMB is the short name used to designate the Medicaid covered group of "Qualified Medicare Beneficiary." A qualified Medicare beneficiary means an individual • who is entitled to enroll for Medicare Part A, • who has resources that are within the resource limits for the Medicare Savings Programs (MSPs). See chapter section M1110.003 for the current resource limits; and
• whose income does not exceed 100% of the FPL. B. Procedure QMB is a mandatory covered group that the state plan must cover for the purpose of paying the beneficiary’s Medicare premiums and cost sharing expenses. See section M0320.601 for the procedures to use to determine if an individual meets the QMB covered group.
M0310.128 RSDI
A. Retirement, Survivors & Disability Insurance (RSDI) Retirement, Survivors & Disability Insurance (RSDI) is another name for Old Age, Survivors & Disability Insurance (OASDI) - the federal insurance benefit program under Title II of the Social Security Act that provides cash benefits to workers and their families when the workers retire, become disabled or die.