Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 359 - MEDICARE SAVINGS PROGRAM
Section 359.109 - Qualified Disabled and Working Individual Program
Universal Citation: 1 TX Admin Code ยง 359.109
Current through Reg. 49, No. 38; September 20, 2024
(a) Authorized under RSA 1396a(a)(10)(E)(ii), the Qualified Disabled and Working Individual (QDWI) Program pays only Medicare Part A premiums for a person who meets the requirements of this section. A person cannot be eligible for regular Medicaid and QDWI coverage at the same time.
(b) To be eligible for QDWI coverage, a person must:
(1) be under 65 years
of age;
(2) be entitled to benefits
under Medicare Part A;
(3) not
otherwise be eligible for Medicaid;
(4) have a monthly income equal to or less
than 200% of the federal poverty level, except for the following exclusions:
(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).
(5) have no more than twice the countable
resources allowed under the Supplemental Security Income (SSI) program, as
described in §1611 of the Social Security Act (RSA
1382), 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's QDWI eligibility begins in accordance with the coverage period described in §1818A of the Social Security Act (RSA 1395i - 2a(c)).
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