Download Reference Documents This page contains helpful tools that provide a deeper dive into the topic of Qualified Medicare Beneficiaries. Here we list timely tools to review, download, and save in your Medicare training documents Cost-Sharing for Medicare Advantage Plans List and Definition of Dual Eligibles Dually Eligible Beneficiaries Under Medicare and Medicaid Prohibition Billing…
QMB Compliance
Types of QMBs The Medicare Savings Programs (MSPs) was developed to assist low-income Medicare beneficiaries. Individuals who qualify for this assistance are often referred to as Dual Eligibles. All dual-eligible beneficiaries qualify for full Medicare benefits, but the extent or level of benefits for which they are eligible under Medicaid can vary. This is often…
FAQ-Billing QMBs
Qualified Medicare Beneficiary Billing FAQ’s Q: Can a provider pass on costs related to excluded (non-covered) services to QMBs? A: Yes, in most cases. QMB rules only apply to Medicare COVERED services, so the billing protections do not apply to excluded Medicare covered services. However, if the patient is a QMB Plus (has full Medicaid coverage), coverage may…