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The conditions of eligibility for the Medicare Savings Program (MSP) are:
· Valid application (MA533);
· Resident of Arizona (MA531);
· Social Security number (MA532);
· US citizen (MA507) or appropriate noncitizen status (MA524);
· Not incarcerated (MA525);
· Apply for potential benefits (MA526);
· Assignment of rights to medical benefits and cooperation (QMB only) (MA503); and
· Income at or below QMB, SLMB or QI-1 requirements (MA615.3, MA615.4 and MA615.5).
Term |
Definition |
Medicare Savings Program (MSP) |
The MSP provides help with Medicare expenses for customers who are entitled to Medicare Part A. NOTE There is no categorical element (i.e., aged, blind or disabled) requirement for the MSP. Persons with End Stage Renal Disease (ESRD) can be eligible, provided they have Medicare Part A.. The MSP offers the following programs: · Qualified Medicare Beneficiary (QMB); · Specified Low-Income Beneficiary (SLMB); and · Qualified Individual-1 (QI-1). |
Qualified Medicare Beneficiary (QMB) |
For customers who: · Meet the general conditions of eligibility; · Are entitled to Medicare Part A (MA523); · Have income less than or equal to 100% FPL. |
Specified Low-Income Medicare Beneficiary (SLMB) |
For customers who: · Meet the general conditions of eligibility; · Receive Medicare Part A (MA523); and · Have income greater than 100% FPL but less than or equal to 120% FPL. NOTE To be eligible for SLMB, a person does not have to be receiving Medicare Part B. |
Qualified Individual-1 (QI-1) |
For customers who: · Meet the general conditions of eligibility; · Receive Medicare Part A (MA523); and · Have income greater than 120% FPL but less than or equal to 135% FPL. NOTE To be eligible for QI-1, a person does not have to be receiving Medicare Part B. |
Customers eligible for the Medicare Savings Program (MSP) receive the Medicare Savings Program Service Package (MA302).
Customers approved for coverage under the Medicare Savings Program (MSP) are enrolled as follows:
If the customer is... |
Then the customer is enrolled in... |
QMB |
Fee-for-Service (FFS) |
· QMB and: · SSI Cash; · SSI MAO; · AHCCCS Freedom to Work; · Caretaker Relative; · Pregnant Women; · Children; · YATI; or · State Adoption Subsidy |
AHCCCS Complete Care (ACC) plan |
QMB and: · ALTCS; or · AHCCCS Freedom to Work – ALTCS |
Program Contractor |
SLMB |
Not enrolled |
· SLMB and: · SSI Cash; · SSI MAO; · AHCCCS Freedom to Work; · Caretaker Relative; · Pregnant Women; · Children; · YATI; or · State Adoption Subsidy |
AHCCCS Complete Care (ACC) plan |
Dual SLMB and AHCCCS Freedom to Work – ALTCS |
Program Contractor |
QI-1 NOTE An individual cannot be eligible for QI-1 and any other Medical Assistance program. |
Not enrolled |
AHCCCS does not charge MSP customers. MSP customers who are not QMBs are responsible for paying to their health care provider:
· Medicare co-payments;
· Medicare deductibles; or
· Medicare co-insurance.
This requirement applies to the following programs:
Program |
Legal Authorities |
Medicare Savings Program (MSP) |
42 USC 1396a(a)(10)(E) Title 36, Chapter 29, Article 3 of the ARS Title 9, Chapter 29 of the AAC |