0865.000.00 Qualified Medicare Beneficiaries (QMB)

0865.035.05 Non-Spend Down May Become Spend Down When Adding QMB

IM-98 December 1, 2023

When a participant becomes eligible for QMB, the Medicare premium (SMI) is no longer an allowable deduction on the MHN budget. This may cause a participant to move from non-Spend Down to Spend Down. Further, any medical expenses paid through QMB cannot be used to meet the participant’s spend down.