All Medicaid Programs

Obsolete Policy

 

Obsolete 0223 - 320-2 QMB

Effective Date: January 1, 2007 - January 31, 2023

Contact DHHS Policy Specialist for Previous Policy

 

Benefits

QMB pays the Medicare premiums for Part A (if applicable), the premiums for Part B and the deductibles and co-payment amounts for Part A and Part B Medicare-covered services.  If an individual who meets all the criteria for QMB coverage, they must pay a premium to receive Part A Medicare, call the OEP Medicaid Program Specialist.  Payment of a Part A Medicare premium is not automatic.

QMB and Other Medicaid Programs

QMB members may be eligible for other Medicaid programs. 

TPL

TPL process is required (225).

Effective Date

The effective date for QMB coverage is the first of the month after the month you determine the member meets all of the criteria for QMB. The member must meet all QMB eligibility criteria in the month before the month you begin QMB coverage.  In addition, the member must still meet all the criteria the month you authorize coverage to begin.  The member must be entitled to Medicare Part A benefits for at least one month before QMB coverage begins.  There is no retroactive coverage.