Missouri Code of State Regulations › Title 13 - DEPARTMENT OF SOCIAL SERVICES › Division 40 - Family Support Division › Chapter 2 - Income Maintenance › Section 13 CSR 40-2.270 - Determining Eligibility for Qualified Medicare Beneficiaries

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule establishes the principles used in
				  determining eligibility for Qualified Medicare Beneficiary coverage on the
				  basis of income, resources and Part A Medicare entitlement.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. Therefore, the material which is so incorporated is on file with
				  the agency who filed this rule, and with the Office of the Secretary of State.
				  Any interested person may view this material at either agency's headquarters or
				  the same will be made available at the Office of the Secretary of State at a
				  cost not to exceed actual cost of copy reproduction. The entire text of the
				  rule is printed here. This note refers only to the incorporated by reference
				  material.
(1) An eligible
				Qualified Medicare Beneficiary shall-
(A) Be
				entitled to and enrolled in Hospital Insurance under Part A of Medicare, as
				described in Section 1811 of the Social Security Act;
(B) Not possess available resources, as
				defined in
				13 CSR
				40-2.030, in excess of twice the individual resource
				maximum of the federal Supplemental Security Income (SSI) program for a single
				person or, if married and actually living with the spouse, the available
				resources of either the Qualified Medicare Beneficiary or the spouse, or both,
				shall not exceed twice the couple resource maximum of the federal SSI program,
				as cited at Section 1611(a)(3) of the Social Security Act;
(C) Not have adjusted gross income in excess
				of one hundred percent (100%) of the federal poverty level beginning January 1,
				1991. For a single person, the adjusted gross income limitation shall be the
				applicable percentage of the poverty level for one (1) person. For a married
				couple living together, the adjusted gross income limitation shall be the
				applicable percentage of the poverty level for two (2) persons. For a married
				couple living together with an eligible dependent child, when one (1) of the
				parents is also eligible, the adjusted gross income limitation shall be the
				applicable percentage of the poverty level for three (3) persons. When an
				eligible dependent child lives with an ineligible parent(s), a portion of the
				income of the parent(s) shall be deemed to be the child's and, in combination
				with the child's own income, be compared to the adjusted gross income
				limitation for a single person. In determining adjusted gross income, the
				following exemptions will be applied to gross income:
1. If the income is earned or unearned, an
				amount of twenty dollars ($20) may be excluded from the gross;
2. The full amount of any SSI payment will be
				excluded; and
3. If the income is
				earned, the twenty dollar ($20) exclusion in paragraph (1)(C)1. will be
				applied, plus the first sixty-five dollars ($65) and one-half (1/2) of the
				remainder of all earned income will be excluded. If a person is a student and
				is under the age of twenty-two (22), the amount of the school expense will be
				excluded from any earned income;
(D) Not have transferred property without
				receiving fair and valuable consideration. Transfers which occur prior to July
				1, 1989 shall cause periods of ineligibility for assistance in accordance with
				section 208.010.2(1), RSMo. Transfers which occur after June 30, 1989 shall
				cause periods of ineligibility in accordance with section 208.010.6., RSMo;
				and
(E) Not possess, prior to
				October 1, 1989, equity in total property in excess of the maximum set out in
				section 208.010.2(5), RSMo.