PM I-04-00: Special Medicare Payment Programs

Special programs help low-income people participate in Social Security Medicare. DPA pays Medicare premiums for these programs. The programs are for:

• A person who has assets at or below twice the SSI asset standard, has income equal to or below the Qualified Medicare Beneficiary (QMB) income standard, and receives Medicare Part A. For QMB cases, DPA pays only:
  • Medicare Part A and Part B premiums; and
  • deductibles for Medicare covered services; and
  • coinsurance charges for Medicare covered services;
• A person who meets all eligibility requirements for QMB, except level of income. This person has more countable income than the QMB income limit, but less than 120% of the Federal Poverty Level. These cases are called Specified Low-Income Medicare Beneficiary (SLIB) cases. DPA pays only Medicare Part B premiums for SLIB cases.
• A person who lost premium-free Medicare Part A coverage because of employment. The person must meet certain income and asset amounts. DPA pays only Medicare Part A premiums for Qualified Disabled Working Individual (QDWI) cases. These cases do not receive a MediPlan Card.

  Local offices do not handle these cases. The Bureau of Program and Field Management Services, Springfield, approves and maintains them.