37.83.401    QUALIFIED DISABLED WORKING INDIVIDUALS, APPLICATION AND ELIGIBILITY FOR MEDICAID

(1) A qualified disabled working individual (QDWI) is an individual:

(a) who is entitled to enroll in hospital insurance benefits (medicare Part A) under 42 USC 1395i-2a because he lost premium-free Part A medicare coverage due solely to excess earned income from substantial gainful activity;

(b) meets the non-financial criteria in (2) of this rule;

(c) whose income does not exceed 200% of the official federal poverty guideline as defined by the executive office of management and budget; and

(d) whose resources do not exceed twice the supplemental security income (SSI) resource limit set forth at 42 USC 1382 (a) (3) (A) and (B) (1990 edition) .

(2) The non-financial criteria for determining eligibility of a qualified disabled working individual are that the person:

(a) has not attained the age of 65;

(b) is blind or disabled as defined in 42 USC 416(i) (1) (1990 edition) .

(c) has a social security number;

(d) meets the citizenship or alienage requirements of ARM 37.82.401; and

(e) meets the residency requirements of ARM 37.82.402.

(3) A person in applying for and receiving medicaid as a qualified disabled working individual is subject to the following provisions:

(a) ARM 37.85.407 concerning third party liability;

(b) ARM 37.82.201 concerning application requirements;

(c) ARM 37.82.204 concerning determinations of eligibility;

(d) ARM 37.82.205 concerning redetermination ;

(e) ARM 37.82.407 concerning limitation on the financial responsibility of relatives;

(f) ARM 37.82.415 concerning application for other benefits; and

(g) ARM 37.82.416 concerning assignment of rights to benefits.

(4) Countable income and resources will be determined using SSI criteria incorporated by reference in ARM 37.82.903(2) .

(5) A person receiving medicaid as a qualified disabled working individual must report within 10 days any changes in circumstances that may affect eligibility.

History: Sec. 53-6-113, MCA; IMP, Sec. 53-6-101 and 53-6-131, MCA; NEW, 1991 MAR p. 1052, Eff. 7/1/91; TRANS, from SRS, 2000 MAR p. 197.