SECTION 359.101. Purpose and Scope  


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  • (a) This chapter describes the assistance available and eligibility requirements for the Medicare Savings Program. Authorized under 42 U.S.C. §1396a(a)(10)(E), the Medicare Savings Program uses Medicaid funds to help eligible persons pay for all or some of their out-of-pocket Medicare expenses, such as premiums, deductibles, or coinsurance.

    (b) The Texas Health and Human Services Commission (HHSC) manages the Medicare Savings Program, which consists of the following:

    (1) the Qualified Medicare Beneficiary (QMB) Program;

    (2) the Specified Low-Income Medicare Beneficiary (SLMB) Program;

    (3) the Qualifying Individual (QI) Program; and

    (4) the Qualified Disabled and Working Individual (QDWI) Program.

    (c) Nothing in these rules shall be construed to violate the maintenance of eligibility requirements of section 5001 of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5) and make eligibility standards, methodologies, or procedures under the Texas State Plan for Medical Assistance (or any waiver under section 1115 of the Social Security Act (42 U.S.C. §1315)) more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) that were in effect on July 1, 2008.

Source Note: The provisions of this §359.101 adopted to be effective September 1, 2009, 34 TexReg 5516; amended to be effective February 3, 2013, 38 TexReg 366