130 CMR, § 519.010

Current through Register 1536, December 6, 2024
Section 519.010 - Medicare Savings Program (MSP) - Qualified Medicare Beneficiaries (QMB)
(A)Eligibility Requirements. MSP (Buy-in) QMB coverage is available to Medicare beneficiaries who
(1) are entitled to hospital benefits under Medicare Part A;
(2) have a countable income amount (including the income of the spouse with whom he or she lives) that is less than or equal to 190% of the federal poverty level;
(3) Effective until February 29, 2024, have countable assets less than or equal to two times the amount of allowable assets for Medicare Savings Programs as identified by the Centers for Medicare and Medicaid Services. Each calendar year, the allowable asset limits shall be made available on MassHealth's website.

Effective March 1, 2024, MassHealth will disregard all assets or resources when determining eligibility for MSP-only benefits; and

(4) meet the universal requirements of MassHealth benefits in accordance with 130 CMR 503.000: Health Care Reform: MassHealth: Universal Eligibility Requirements or 130 CMR 517.000: MassHealth: Universal Eligibility Requirements, as applicable.
(B)Benefits. The MassHealth agency pays for Medicare Part A and Part B premiums and for deductibles and coinsurance under Medicare Parts A and B for members who establish eligibility for MSP coverage in accordance with 130 CMR 519.010(A).
(C)Begin Date. The begin date for MSP coverage is the first day of the calendar month following the date of the MassHealth eligibility determination.

130 CMR, § 519.010

Amended by Mass Register Issue 1327, eff. 12/2/2016.
Amended by Mass Register Issue 1407, eff. 1/1/2020.
Amended by Mass Register Issue 1409, eff. 1/1/2020.
Amended by Mass Register Issue 1496, eff. 5/12/2023 (EMERGENCY).
Amended by Mass Register Issue 1502, eff. 5/12/2023 (EMERGENCY).
Amended by Mass Register Issue 1508, eff. 5/12/2023 (EMERGENCY).
Amended by Mass Register Issue 1509, eff. 11/24/2023.
Amended by Mass Register Issue 1512, eff. 11/24/2023.
Amended by Mass Register Issue 1514, eff. 11/24/2023.