01/18/21
Qualified Medicare Beneficiary Program
Lately, I have been receiving questions regarding Medicare beneficiaries who are dually eligible (have Medicare primary and Medicaid secondary) and are enrolled in the Qualified Medicare Beneficiary (QMB) program. Medicare beneficiaries enrolled in the QMB program are also enrolled in Medicaid and get help with their Medicare premiums and cost-sharing. What providers want to know is can they bill the Medicare beneficiary who is enrolled in the QMB program for the 20% co-insurance the Medicare program does not cover as well as any deductible the Medicare beneficiary has not met yet if the Medicaid program does not pay that portion?
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