BIL: Buy-In History Inquiry

How to read the BIL screen to know what is happening with a buy-in benefit.

How to Certify QI-1

QI-1 can be certified effective three months prior to the month of application, if all factors of eligibility were met all three months. For additional information regarding factors of eligibility for QI-1, refer to article ABD: Qualified Individuals – Group 1 (QI-1). If all factors of eligibility were NOT met prior to month of application, […]

Appendix C-1

Link to Appendix C-1

Income – Social Security COLA and Continued Eligibility

When the annual COLA makes a client over income, the benefit can stay open till the new standards come out.

How to Code for Eligible Couple (Short Term Medical)

Determine eligibility for an eligible couple & FACS Coding for Short Term Medical

Medicare Information

Medicare has four parts each covering something different. Part A: covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. People who have worked 40 quarters do not pay a premium. Those who have not worked 40 quarters, like many SSI recipients, will have to pay a significant […]

Qualifying Individual (QI-1)

Qualifying Individual (QI-1) – means certain aged, blind or disabled individuals who are enrolled in Medicare Part A, meet the Medicaid Qualifying Individual income and resource standards and meet all other Medicaid eligibility requirements. When approved for QI-1, Medicaid pays for the Medicare Part B premium. A QI recipient cannot be receiving or eligible for […]


Medicare – -means the federally funded health insurance program also known as Title XVIII of the Social Security Act.  It consists of four separate programs.  Part A is Hospital Insurance, Part B is Medical Insurance, Part C is Medicare Advantage Plans, and Part D is Prescription Drug Coverage.  Policy regarding this term is located at: […]


Buy-In – means the procedure whereby the Oklahoma Health Care Authority pays the person’s Medicare premium.

Qualified Individuals – Group 1 (QI-1)

Definition of QI-1