This webinar took place on Wednesday, July 24, 2019 11 am-12 pm PT/2-3 pm ET. The Qualified Medicare Beneficiary (QMB) program provides significant Medicare cost savings to low income individuals, including payment of Medicare premiums and protection from liability for any Medicare co-insurance or deductibles for health services. Those enrolled in the program also are […]
This webinar took place on Tuesday, July 23, 2019 11 am-12 pm PT/2-3 pm ET. The Qualified Medicare Beneficiary (QMB) program provides significant Medicare cost savings to low income individuals, including payment of Medicare premiums and protection from liability for any Medicare co-insurance or deductibles for health services. Those enrolled in the program also are […]
More dual eligibles—individuals with Medicare and Medicaid—are enrolling in a certain type of Medicare Advantage plan as a result of aggressive marketing efforts targeting dual eligibles. This type of plan, known as a Dual Eligible Special Need Plan (D-SNP) Look-Alike, threatens to undermine promising advancements in integrated care for duals made possible by the Affordable […]
The Centers for Medicare and Medicaid Services (CMS) recently finalized rules implementing regulations governing minimum integration standards for Dual Eligible Special Needs Plans (D-SNPs) pursuant to the Bipartisan Budget Act of 2018. D-SNPs are Medicare Advantage plans that limit enrollment to individuals who are dually eligible for Medicare and Medicaid. With the permanent authorization of […]
CalMediConnect, launched in 2014, is California’s dual eligible demonstration and seeks to integrate Medicare and Medicaid benefits under one health plan. One of its purposes is to better meet the needs of dual eligibles by increasing access to long-term services and supports (LTSS) and providing other value-added services, known in the demonstration as Care Plan […]
This webinar took place on Monday, September 24, 2018. The Qualified Medicare Savings Program (QMB) helps low-income Medicare beneficiaries pay for their health insurance by covering Part A and B premiums and cost-sharing. State Medicaid programs, which administer QMB, have a responsibility to screen for eligibility, but many individuals still face challenges enrolling into the […]
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 […]
When: Monday, October 2, 2017 at 11:00 a.m. PT/ 2:00 p.m. ET. Medicare providers are prohibited from billing Qualified Medicare Beneficiaries (QMBs) for any Medicare co-payments or deductibles. This includes most dual eligibles. However, the problem of improper billing persists.
Ensuring that Qualified Medicare Beneficiaries (QMBs) are not illegally billed for Medicare costs requires improvements on many fronts. One important piece is better identifying QMBs and informing both QMB consumers and their providers that they are subject to billing protections. Justice in Aging is pleased to share two new important resources contributing to that effort. […]
Doctors, hospitals, and other providers often bill dual eligible Medicare beneficiaries and Qualified Medicare Beneficiaries (“QMBs”) for services that should be covered under Medicare or Medicaid. This practice of improper billing is illegal and can cause low-income beneficiaries to go into debt, skip needed medical care, or end up without sufficient funds to pay for […]