Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.83 - MEDICAID FOR CERTAIN MEDICARE BENEFICIARIES AND OTHERS
Subchapter 37.83.4 - Medicaid for Qualified Disabled Working Individuals
Rule 37.83.401 - QUALIFIED DISABLED WORKING INDIVIDUALS, APPLICATION AND ELIGIBILITY FOR MEDICAID

Universal Citation: MT Admin Rules 37.83.401

Current through Register Vol. 18, September 20, 2024

(1) A qualified disabled working individual (QDWI) is an individual:

(a) who is entitled to enroll in hospital insurance benefits (medicare Part A) under 42 USC 1395i-2a because he lost premium-free Part A medicare coverage due solely to excess earned income from substantial gainful activity;

(b) meets the non-financial criteria in (2) of this rule;

(c) whose income does not exceed 200% of the official federal poverty guideline as defined by the executive office of management and budget; and

(d) whose resources do not exceed twice the supplemental security income (SSI) resource limit set forth at 42 USC 1382 (a) (3) (A) and (B) (1990 edition).

(2) The non-financial criteria for determining eligibility of a qualified disabled working individual are that the person:

(a) has not attained the age of 65;

(b) is blind or disabled as defined in 42 USC 416 (i) (1) (1990 edition).

(d) meets the citizenship or alienage requirements of ARM 37.82.401; and

(e) meets the residency requirements of ARM 37.82.402.

(3) A person in applying for and receiving medicaid as a qualified disabled working individual is subject to the following provisions:

(a) ARM 37.85.407 concerning third party liability;

(b) ARM 37.82.201 concerning application requirements;

(d) ARM 37.82.205 concerning redetermination ;

(e) ARM 37.82.407 concerning limitation on the financial responsibility of relatives;

(f) ARM 37.82.415 concerning application for other benefits; and

(g) ARM 37.82.416 concerning assignment of rights to benefits.

(4) Countable income and resources will be determined using SSI criteria incorporated by reference in ARM 37.82.903(2).

(5) A person receiving medicaid as a qualified disabled working individual must report within 10 days any changes in circumstances that may affect eligibility.

Sec. 53-6-113, MCA; IMP, Sec. 53-6-101 and 53-6-131, MCA;

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