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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 52 Chapter 23 Specific Medicaid Requirements

23.12 MEDICARE PREMIUM SUBSIDIES Individuals who meet all other Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLIMB), and Qualified Individuals (QI) eligibility requirements, but who are not yet enrolled in Part B, must be referred to the Bureau of Medical Services (BMS) Medicare Buy-In Unit by sending an email to: DoHSmedicarebuyin@wv.gov. The message must contain the applicant’s name, address, date of birth, and Social Security Number. The Buy-In Unit contacts Social Security to facilitate enrollment. This avoids any late enrollment penalty that may apply to the individual and permits enrollment outside the yearly open enrollment period. 23.12.1 QUALIFIED MEDICARE BENEFICIARIES (QMB) Income Assets 100% FPL $9,950 – Individual $14,910 – Couple Medicaid coverage is limited to payment of the Medicare, Part A and Part B premium amounts and payment of all Medicare co-insurance and deductibles, including those related to nursing facility services. The Buy-In Unit pays the Medicare premium. Refer to Chapter 25 for details. An individual or couple (spouses) is eligible for this limited Medicaid coverage when all the following conditions are met: • The individual must be entitled to premium-free Medicare Part A and/or enrolled in Medicare Part B. He must be entitled to Medicare in any of the following three ways: o By being age 64 years and 9 months old or older; o By having been totally and continuously disabled and receiving RSDI or Railroad Retirement benefits for 24 months or longer; or, o By having end-stage renal disease; • The individual or spouses must meet the income test detailed in Chapter 4; and, • The individual or spouses must meet the asset test detailed in Chapter 5.