Medicaid can pay for Medicare expenses in situations where a recipient is Medicare eligible, but not Medicaid eligible, if the household income leaves them “dually” qualified for both Medicare and Medicaid payment assistance.
Qualified Medicare Beneficiary Program (QMB). The household countable income is greater than the SSI threshold, but no more than the poverty line. For 2018 the income threshold is $1,012 for an individual and $1,372 for a couple. Deeming applies, and is considered to be $360 if deeming is present. The countable resource limit is $7,560 for an individual and $11,340 for a couple.
This program pays for: Part A premium, Part B premium, Deductibles, Coinsurance
Specified Low-Income Medicare Beneficiary (SLMB). The household countable income is 100% to 120% of the poverty line. The income threshold is $1,214 for an individual and $1,646 for a couple. Deeming is considered to be $432. The countable resource limit is $7,560 for an individual and $11,340 for a couple. The program pays Part B premium.
Qualifying Individual (QI-1) The household countable income is 120% – 135% of the poverty line. However, the state only has a limited amount of funding for this program available. Individuals have to be approved every year, and funding has to be available every year. Priority is given to current recipients, and is generally administered in as first come first serve for renewals, and then first come first serve for new recipients until funding is exhausted. The income threshold is $1,366 for an individual and $1,852 for a couple. Deeming is considered to be $486. The countable resource limit is $7,560 for an individual and $11,340 for a couple. The program pays Part B premium.
Qualified Disabled Working Individual (QDWI) The household countable income is up to 200% of the poverty line.
The income threshold is $2,024 for an individual and $2,724 for a couple. Deeming is considered to be $720. The countable resource limit is 2x the SSI limit (presently $4,000 individual and $6,000 couple). The program pays Part A premium.