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Advance Beneficiary Notices, Administrative Fees, and Dual Eligibles

Federal law prohibits charging Qualified Medicare Beneficiaries (QMBs) with Medicare cost-sharing for covered services. Depending on state law, other beneficiaries who are fully eligible for both Medicare and Medicaid–full benefit dual eligibles–may also be protected from being billed for co-payments or other forms of cost sharing.

However, QMBs and other dual eligibles may still be responsible for certain charges or fees. A new Justice in Aging Issue Brief: Advance Beneficiary Notices, Administrative Fees, and Dual Eligibles explains for advocates the situations under which these types of beneficiaries may be responsible for charges.

Read the brief to learn what protections QMBs have and what charges they may have to pay.

Additional Justice in Aging resources on improper billing can be found here.

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