QI-1 definition
Examples of QI-1 in a sentence
A Full Benefit Dual Eligible Member does not include those persons enrolled in a Medicare Savings Program population: Qualified Medicare Beneficiary only (QMB only), Specified Low- Income Medicare Beneficiary only (SLMB only) or Qualified Individual-1 (QI-1).
All individuals meeting the definition of QMB, SLMB, or QI-1, or those with income below 135 percent of poverty who were not eligible to receive drug benefits under Medicaid, could receive assistance with their prescription drug costs, effective January 1, 2004.
The benefit package for the SLMB and QI-1 population would be defined as having a zero deductible, 5.0% cost-sharing for costs below the initial coverage limit; 10.0% cost-sharing for costs above the initial coverage limit and below the annual catastrophic limit, and 2.5% cost-sharing for costs above the catastrophic limit.
The monthly income limit for QI-1 for an individual is $1,031 and for a couple $1,384 ($12,372 per year for an individual and $16,608 for a couple).
Eligibility determinations for Medicaid, QMB, SLMB, and QI-1 programs are made by the states.
However, expenditures under the QI-1 program are paid 100% by the federal government (from the Part B trust fund) up to the state’s allocation level.
As part of the eligibility determination process, states would also be required to screen for eligibility for Medicare cost-sharing assistance under the QMB, SLIMB, and QI-1 programs.
The provision would extend the QI-1 program through December 2008 with total annual allocations of $400 million through fiscal year 2008 and $100 million for the first quarter of fiscal 2009.
Persons meeting the definition of QMB, SLMB, or QI-1, and not eligible for Medicaid medical and drug benefits, as well as other persons below 160% of the federal poverty level, would receive their drug benefits through Part D.
Assistance under the QI-1 program, originally available for the period January 1, 1998 to December 31, 2002, has been extended to March 31, 2004.