Ariz. Admin. Code § 9-29-101

Current through Register Vol. 30, No. 37, September 13, 2024
Section R9-29-101 - Location of Definitions
A. Location of definitions. Definitions applicable to this Chapter are found in the following:

Definition Section or Citation
"Federal poverty level" or "FPL" A.R.S. § 36-2981
"Medicare Cost Sharing" R9-29-101
"Non-QMB Dual" R9-29-101
"QI-1" R9-29-101
"QMB Dual" R9-29-101
"QMB Only" R9-29-101
"SLMB" R9-29-101

B. General definitions. In addition to definitions contained in A.R.S. § 36-2971, the words and phrases in this Chapter have the following meanings unless the context explicitly requires another meaning:

"Medicare Cost Sharing" (MCS). The MCS Program is administered by the Administration and provides help to Medicare beneficiaries with costs related to Medicare services. MCS is also referred to as the "Medicare Savings Programs."

"Non-QMB Dual" means a person who qualifies to receive both Medicare and Medicaid services, but does not qualify for the QMB program.

"QI-1" means a person who qualifies as a Medicare beneficiary and for cost sharing assistance with the person's Part B premium known as Qualified Individual-1 (QI-1). This person does not qualify for QMB due to the person's income exceeding the QMB and SLMB FPL level.

"QMB Dual" means a person determined eligible under Article 2 of this Chapter for Qualified Medicare Beneficiary (QMB) and eligible for Acute Care services provided for in 9 A.A.C. 22 or ALTCS services provided for in 9 A.A.C. 28. A QMB Dual person receives both Medicare and Medicaid services and cost sharing assistance. For the purpose of Article 2 of this Chapter, QMB includes members defined in A.R.S. § 36-2971(5).

"QMB Only" means a person who qualifies to receive Medicare services only and cost-sharing assistance known as Qualified Medicare Beneficiary program (QMB). For the purpose of Article 2 of this Chapter, QMB includes members defined in A.R.S. § 36-2971(5).

"SLMB" means a person who qualifies as a Medicare beneficiary and for cost sharing assistance with the person's Part B premium known as Specified Low Income Medicare Beneficiary (SLMB). This person does not qualify for QMB due to the person's income exceeding the QMB FPL level.

Ariz. Admin. Code § R9-29-101

Adopted effective May 23, 1990 (Supp. 90-2). Amended effective June 16, 1992 (Supp. 92-2). Amended effective April 14, 1998 (Supp. 98-2). Amended by final rulemaking at 6 A.A.R. 3372, effective August 7, 2000 (Supp. 00-3). Amended by exempt rulemaking at 7 A.A.R. 4357, effective October 1, 2001 (Supp. 01-3). Amended by final rulemaking at 9 A.A.R. 5142, effective January 3, 2004 (Supp. 03-4). Amended by final rulemaking at 18 A.A.R. 3139, effective January 6, 2013 (Supp. 12-4).