0865.010.00 Eligibility Requirements

0865.010.10.05 Assistance Group

Although QMB eligibility is determined on an individual basis, the income and resources of certain household members are considered when establishing need.

Those whose income and resources are to be considered are:

  • the claimant
  • the claimant’s spouse, if living together; and
  • Part A eligible dependent children in the home

NOTE: Dependent children are not considered in the assistance group with a Part A eligible parent unless they are also eligible for Part A Medicare.

Part A Medicare eligible dependent children (under age 18) of parents who are ineligible for QMB are subject to the deeming procedures of Medical Assistance for Disabled Children. Refer to Section 0805.020.00 Medical Assistance for Disabled Children (MADC).

For married couples living together, include both in the assistance group, even if one is receiving another type of assistance.