1. (a) Authorized under 42 U.S.C. §1396a(a)(10)(E)(i), the Qualified Medicare Beneficiary (QMB) Program pays Medicare premiums, deductibles, and coinsurance for a person who meets the requirements of this section. A person receiving Medicaid may also receive QMB benefits if the person meets the requirements of this section.

2. (b) To be eligible for QMB coverage, a person must:

   1. (1) be entitled to benefits under Medicare Part A; and
   2. (2) meet income and resources requirements in 42 U.S.C. §1396d(p).

3. (c) A person is not eligible for QMB coverage if the person:

   1. (1) is in the custody of penal authorities as defined in 42 C.F.R. §411.4(b); or
   2. (2) is over 20 years of age and under 65 years of age and resides in an institution for mental diseases.
4. (d) A person's QMB eligibility begins on the first day of the month after the month the person is certified for QMB benefits.
5. (e) A person with QMB coverage is not eligible for three months prior medical coverage.

Source Note:The provisions of this §359.103 adopted to be effective September 1, 2009, 34 TexReg 5516.