Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 359 - MEDICARE SAVINGS PROGRAM
Section 359.103 - Qualified Medicare Beneficiary Program
Universal Citation: 1 TX Admin Code ยง 359.103
Current through Reg. 49, No. 12; March 22, 2024
(a) Authorized under RSA 1396a(a)(10)(E)(i), the Qualified Medicare Beneficiary (QMB) Program pays Medicare premiums, deductibles, and coinsurance for a person who meets the requirements of this section. A person receiving Medicaid may also receive QMB benefits if the person meets the requirements of this section.
(b) To be eligible for QMB coverage, a person must:
(1) be entitled to benefits under
Medicare Part A;
(2) meet income
requirements in
RSA
1396d(p), except
for:
(A) payments made from or interest
earned on a tuition savings program under §
RSA
358.388 of this title (relating to Tuition
Savings Programs);
(B) payments
made from or interest earned on an Achieving a Better Life Experience (ABLE)
account under § 358.389 of this title (relating to Achieving a Better Life
Experience Program); and
(C)
income earned on a school-based savings program under § 358.390 of this
title (relating to School-Based Savings Program).
(3) meet resource requirements in
RSA
1396d(p), except
for:
(A) funds used to establish a tuition
savings program under §
RSA
358.356 of this title (relating to Tuition
Savings Programs);
(B) funds used
to establish an ABLE account and funds held in an ABLE account under §
358.357 of this title (relating to Achieving a Better Life Experience Program);
and
(C) funds held in a
school-based savings program under § 358.358 of this title (relating to
School-Based Savings Program).
(c) A person is not eligible for QMB coverage if the person:
(1) is in the custody of penal
authorities as defined in
RSA
411.4(b);
or
(2) is over 20 years of age and
under 65 years of age and resides in an institution for mental
diseases.
(d) A person's QMB eligibility begins on the first day of the month after the month the person is certified for QMB benefits.
(e) A person with QMB coverage is not eligible for three months prior medical coverage.
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