Idaho Admin. Code r. 16.03.05.812

Current through September 2, 2024
Section 16.03.05.812 - QUALIFIED INDIVIDUAL (QI)

A person meeting all requirements below is eligible for QI. Medicaid pays the Medicare Part B premiums for a QI. The income and resource exclusions and disregards used for AABD are used for QI.

01.Other Medicaid. The QI cannot be eligible for any other type of Medicaid.
02.Medicare Part A. The QI must be entitled to hospital insurance under Part A of Medicare at the time of their application.
03.Nonfinancial Requirements. The QI must meet the Medicaid eligibility requirements of residence, citizenship, support cooperation, and SSN.
04.Income. The annual Social Security cost of living increase is disregarded from income, until the month after the month the annual FPG revision is published. The single person limit is based on a family of one (1). The couple limit is based on a family of two (2). The monthly income limit is up to one hundred thirty-five percent (135%) of the FPG.
05.Resource Limit. The resource limit is equal to the amount defined under 42 USC 1396d(p)(1)(C). The resource exclusions used for AABD are used for SLMB.
06.Coverage Limits. There is an annual limit on participants served based on availability of federal funds. New applications are denied when the annual limit is reached.
07.Effective Dates. QI coverage begins on the first day of the application month, which may be backdated up to three (3) calendar months before the application month.

Idaho Admin. Code r. 16.03.05.812

Effective July 1, 2024