523 Medicare

A customer must be entitled to Medicare Part A to qualify for the Medicare Savings Program (MSP):

A customer who is entitled to Medicare Part A or Part B cannot qualify for the Adult Group.

Term	Definition
Medicare	A federal health insurance program run by the Social Security Administration (SSA) for: People age 65 years old and older; Some people under age 65 with disabilities; and People with End-Stage Renal Disease. For more information about Medicare go to http://www.medicare.gov
Medicare Part A	Hospital insurance that pays for covered hospital care, limited skilled nursing facility care, hospice care, and some home health services. Most people do not have to pay a monthly premium for Medicare Part A. People who must pay a premium to get Part A can apply for conditional enrollment in Medicare Part A.
Medicare Part B	Medical insurance that pays for certain physician’s services, including surgery, outpatient hospital care, home health services, and some other items and services not covered under Medicare Part A. There is a monthly premium for Medicare Part B coverage.
Conditional enrollment for Medicare Part A	An application for enrollment in Medicare Part A on the condition that QMB eligibility is approved. If QMB is not approved, the customer is not enrolled in Medicare Part A.

Use Social Security records to see if the customer is entitled to or receiving Medicare Part A and Medicare Part B.

Program

Legal Authorities

Medicare Savings Program (MSP)

42 USC 1396d(p)(1)(A)

AAC R9-29-204(7)

Adult

42 CFR 435.119(b)(3)