Recipient Eligibility
Eligibility Categories
Limited Benefit Categories
Qualified Medicare Beneficiary-Only Recipients
Qualified Medicare Beneficiary-Only recipients are a limited benefit category of Medicaid recipients. The only benefits they receive from Wisconsin Medicaid are payment of the following:
- Medicare monthly premiums for Part A, Part B, or both.
- Coinsurance, copayment, and deductible for Medicare-allowed services.
Qualified Medicare Beneficiary-Only recipients are certified by their county/tribal social or human services agency. Qualified Medicare Beneficiary-Only recipients are required to meet the following qualifications:
- Have an income under 100 percent of the FPL.
- Be entitled to, but not necessarily enrolled in, Medicare Part A.
- Not be receiving other Medicaid benefits.
Qualified Medicare Beneficiary-Only recipients receive a Forward identification card. Refer to the Medicaid Identification Cards chapter of this section for more information.
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