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Medicaid and Medicare Coverage:

Some individuals who have low income qualify for both Medicaid and Medicare. These individuals are referred to as "Dual Eligibles". Medicaid helps pay premiums for Medicaid beneficiaries who are aged or disabled and have low incomes. This is extra financial support for Medicare Premiums or other out of pocket expenses.  In Indiana there are four categories of dual eligibles:

Qualified Medicare Beneficiary (QMB):

To be eligible in this category you must be entitled to Medicare Part A. Medicaid will pay for your monthly premium for Medicare Part B and any deductibles and coinsurance and for some individuals the monthly premium for Medicare Part A if they meet income and resource limits.  Your countable income must be less than 100% of the Federal Poverty Level and your resources must be less than $4,000 per individual or $6,000 per married couple.

Specified Low Income Medicare Beneficiary (SLMB):

To be eligible in this category an individual must be entitled to Medicare Part A. Medicaid will pay the individual’s Medicare Part B premium. An individual can be eligible for SLMB and full coverage of Medicaid.  Your countable income must be between 100% of the Federal Poverty Level and less than 120% of the Federal Poverty Level.  Your resources must be less than $4,000 per individual and $6,000 per married couple.

Qualified Disabled Working Individual (QDWI):

To be eligible in this category you must have Medicare Part A and countable income below 200% of the Federal Poverty Level.  You may have lost or will lose premium-free Medicare Part A coverage because of your earnings from employment. Medicaid will help only by paying your premium for Medicare Part A. An individual is not eligible under this category if they are eligible for Medicaid under any other category.

Qualified Individuals (QI):

To be eligible in this category, an individual must be entitled to Medicare Part A and have countable income between 120% and 135% of the Federal Poverty Level. Medicaid will pay only for your Part B premium.  To be eligible, you must meet Indiana’s income and resource guidelines.  This is a federal block grant program, so the availability for this program is limited.

GET HELP WITH MEDICARE QUESTIONS:

To get individualized help with Medicare questions, you may contact a State  Health Insurance Program (SHIP) counselor at 1-800-452-4800.

To understand more about Medicare visit the following sites:

 

The Disability Benefits and Work website was funded by the Medicaid Infrastructure Grant (CFDA # 93.768)

This site is intended for informational purposes only. Individual situations vary widely and must be evaluated on an individual basis by Division of Family Resources eligibility caseworkers, or Social Security Claims Representatives and/or Indiana Works-Community Works Incentive Coordinators. Links from this site are provided to help people research various topics and do not constitute endorsements by the State of Indiana or its partners.