Depending on their income, dual eligibles can qualify as Qualified Medicare Beneficiaries (QMBs
), Specified Low-Income Medicare Beneficiaries (SLMBs), or Qualified Individuals (QIs)-QMBs are assisted with Medicare Part B premiums and co-payments.
For example, even though the federal government defines the categories of people who qualify for assistance, a QMB
in one state might be a SLMB in another.
The authority of state and local governments to issue QMBs
has been expanded after Aug.
"Bridging the Gaps between Medicare and Medicaid: The Case for QMBs
and SLMBs." American Association of Retired Persons, Washington DC.
"Bridging the Gaps between Medicare and Medicaid: The Case of QMBs
and SLMBs" [accessed on May 11, 2005].
were more likely to be in Medicaid, relative to MA plans ([beta]=-0.738, p<0.012).
only, SLMB only, qualified disabled and working individuals--QDWIs or qualifying individuals--QI1s or QI2s) (Centers for Medicare & Medicaid Services, 2004a).
Under Federal policy, full-benefit dually eligible beneficiaries and QMBs
are not liable for these FFS cost-sharing requirements as Medicare copays and deductibles are covered under their Medicaid benefit--although State practices vary regarding the level of payment, as permitted under the Balanced Budget Act of 1997 (Mitchell and Haber, 2001).
To examine implementation of the Qualified Medicare Beneficiary (QMB
) and Specified Low-Income Medicare Beneficiary (SLMB) programs, enacted in 1988.
Aged Medicare beneficiaries whose income is below 100 percent of the FPL and whose resources do not exceed twice the allowable amount under SSI, also known as QMBs
Mandatory managed care design for all Medicaid-eligibles (except QMBs
and SLMBs); MCOs cover medical, acute behavioral, and dental care.(3) Number and Type of Managed Demonstration Enrollment State Care Plans as of 1999(1) as of July 1999 Hawaii 6 Total; 5 Commercial 118,112 1 Medicaid Dominant Plan Oklahoma 4 Total; 2 Commercial, 201,737 2 Medicaid Dominant Plans Rhode Island 4 Total; 3 Commercial, 87,717 1 Medicaid Dominant Plan Tennessee 9 Total; 5 Commercial, 1,284,264 4 Medicaid Dominant Plans (1) Commercial plans serve mostly non-Medicaid members in that State, while Medicaid-dominant plans are those with only or mostly Medicaid members in that State.
The impact of this trend on Medicaid expenditures was largely offset, however, by expansions in coverage, including the creation of Qualified Medicare Beneficiaries (QMBs
) and Specified Low-Income Medicare Beneficiaries (SLMBs).