QMB+ with no Medicare?

[policywunk]

It is true in every state however how you apply for it and how your state pays it is different. I get that the document attached is dated but the ruling still applies that all states must cover it. The distinction is if they are a buy-in state or group payer. The majority of states are buy-in.

If you actually look at CMS you get the black and white answer. Unfortunately, some states make it way more complicated than it should be.
State Payment of Medicare Premiums | CMS

For those getting SSI sometimes SSA enrolls and pays for part B buy -in instead of the state.

Q12. What is the difference between an SSI auto-accrete state and an alert state? Some states have “1634” agreements with SSA that enable SSA to make Medicaid eligibility determinations for individuals receiving Supplemental Security Income (SSI) benefits. These states are known as “auto-accrete” states because CMS will automatically enroll (“accrete”), on behalf of the state, SSI beneficiaries in Part B buy-in. Other states are referred to as “alert” states. In alert states, CMS identifies for states SSI recipients who are Medicare-eligible, but the state determines Medicaid eligibility and initiates Part B buy-in enrollment. Please see chapter 1, section 1.6.1.1 and chapter 2, section 2.5.1 of the manual for more information.

 

[DonP]

For those getting SSI sometimes SSA enrolls and pays for part B buy -in instead of the state.

Q12. What is the difference between an SSI auto-accrete state and an alert state? Some states have “1634” agreements with SSA that enable SSA to make Medicaid eligibility determinations for individuals receiving Supplemental Security Income (SSI) benefits. These states are known as “auto-accrete” states because CMS will automatically enroll (“accrete”), on behalf of the state, SSI beneficiaries in Part B buy-in. Other states are referred to as “alert” states. In alert states, CMS identifies for states SSI recipients who are Medicare-eligible, but the state determines Medicaid eligibility and initiates Part B buy-in enrollment. Please see chapter 1, section 1.6.1.1 and chapter 2, section 2.5.1 of the manual for more information.

A great majority of over 65 ssi people I run into have part b . And I agree with Vic . Much cheaper for Medicaid to pay the $560 a month part a premium and stock those huge hospital bills on Medicare . . I’m trying to find the exact way to do it

 

[KandKsmommy]

For those getting SSI sometimes SSA enrolls and pays for part B buy -in instead of the state.

Q12. What is the difference between an SSI auto-accrete state and an alert state? Some states have “1634” agreements with SSA that enable SSA to make Medicaid eligibility determinations for individuals receiving Supplemental Security Income (SSI) benefits. These states are known as “auto-accrete” states because CMS will automatically enroll (“accrete”), on behalf of the state, SSI beneficiaries in Part B buy-in. Other states are referred to as “alert” states. In alert states, CMS identifies for states SSI recipients who are Medicare-eligible, but the state determines Medicaid eligibility and initiates Part B buy-in enrollment. Please see chapter 1, section 1.6.1.1 and chapter 2, section 2.5.1 of the manual for more information.

We were specifically talking about Part A and if all states pay for it for QMB recipients. Yes Part B and autoenrollment are also different. ME is listed as an accrete state but they do actually require an application to get MaineCare even when someone is approved for SSI. They will however use SSI's determination of disability instead of requiring a separate one for disability MaineCare.

Unfortunately, there is also issues with what bucket the money comes from as to what they count against the client and estate recovery. In ME if you are Non-MAGI category so MSP, Disabled, and Worker with Disabilities they count your assets but if you're under 64 not on Medicare, and not disabled they don't count assets. Then there is estate recovery on Full MaineCare (and some other types for over 55 even with MAGI) but not MSP. There is also a spend-down Medicaid.

Really your state's Health and Human Services is the best reference although they are not always well versed in their own programs. That's why it is always good to do a little research. We thankfully have a group called Consumers for Affordable Healthcare which offers seminars on all things Medicaid and Marketplace and I have taken their training a few times and reach out to them when I have the odd situation.