Arizona Laws 36-2973. Qualified medicare beneficiary only; eligibility determination; application; enrollment
A. The administration shall determine the eligibility of all applicants who may be eligible as qualified medicare beneficiaries only. The administration shall ensure that the calculation of income eligibility requirements is in accordance with federal law and the section 1115 waiver. On determination of qualified medicare beneficiary only eligibility, the administration shall enroll the member in the system.
Terms Used In Arizona Laws 36-2973
- Administration: means the Arizona health care cost containment system administration. See Arizona Laws 36-2971
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
- Contract: A legal written agreement that becomes binding when signed.
- Contractor: means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 to provide health care to members under this article either directly or through subcontracts with providers. See Arizona Laws 36-2971
- Director: means the director of the Arizona health care cost containment system administration. See Arizona Laws 36-2971
- Member: means an eligible person who enrolls in the system and who is defined as a qualified medicare beneficiary pursuant to section 1905(p) of title XIX of the social security act and whose income does not exceed one hundred per cent of the federal poverty guidelines. See Arizona Laws 36-2971
- Qualified medicare beneficiary only: means an eligible person who is determined eligible pursuant to this article and who is not enrolled as a member under either article 1 or 2 of this chapter. See Arizona Laws 36-2971
- System: means the Arizona health care cost containment system established by article 1 of this chapter and the Arizona long-term care system established by article 2 of this chapter. See Arizona Laws 36-2971
B. The administration may enroll the member who has been determined eligible as a qualified medicare beneficiary only in a fee-for-service arrangement. The director may enter into a contract with a medicare risk contractor that, in accordance with section 1876 of the social security act, has a contract with the health care financing administration and may pay premiums for enrollment of that member.