What is the difference between qmb and qmb

Browse by Category. Other Resources. About Us. Help Center. Privacy and Terms of Use. Video Guides. Quick Info. Program Contact Additional Info Qualified Medicare Beneficiary. Managing Agency U. Department of Health and Human Services. Check if you may be eligible for this benefit. Medicaid does not limit deductible or coinsurance payments to services covered by the State Plan. Monthly income must be not more than percent FPL. QMB eligibility begins on the first day of the month following the month the person is determined eligible for QMB benefits.

The disposition date in the system of record is the date the eligibility decision is completed. The only exception is if the individual is eligible for continuous QMB. A person does not reside in the institution during the entire three prior months. This situation occurs when there has been a decrease in countable ongoing income or when deemed income or support and maintenance was countable in the prior months.

This situation occurs when there has been a decrease in countable ongoing income, such as additional income was received in the prior months. Living in the community , including persons applying for Community Attendant Services CAS and persons residing at home and applying for Home and Community-Based Services waiver programs:. QI-1 persons cannot be eligible for regular Medicaid and QI-1 benefits at the same time. Always give applicants the opportunity to choose which benefit they prefer to receive and document the person's verbal or written choice of preferred benefit, including a choice between QI-1 and CAS benefits.

For QI-1, the three months prior period cannot extend back into the previous calendar year unless the application was filed in that calendar year. The application file date and prior coverage months must be in the same calendar year. Example 1: February is the application month, which makes January the only possible prior coverage month. Example 2: December is the application month; thus, the three months prior would be September, October and November.

Applicant could be potentially eligible for the three months prior, the application month of December and for January and ongoing. In addition, there are other programs to help low-income Medicare beneficiaries pay for Medicare cost sharing. It is important to note that the savings for low-income Medicare beneficiaries are available whether the individual receives the Medicare Part A and B services through traditional Medicare fee-for-service or a Medicare Advantage health plan.

However, for most Medicare consumers, Medicare Advantage plans offer lower overall cost sharing than unmanaged fee-for-service. Of course, for Medicare beneficiaries, the best sources of consumer information is the Medicare. SHIP offices offer one-on-one counseling and assistance to Medicare beneficiaries and their families.

Finally, the Piper Report has dozens of other articles on dual eligible issues you may find interesting. Friday, November 12, Piper Report. What is your marital status?

What is your average monthly income? Please provide your contact information so a trained benefits enrollment counselor can be in touch to discuss your eligibility and assist you with the application process.

Each state offers a SHIP, partly funded by the federal government, to give you free counseling and assistance. A SHIP counselor may be available by phone or in person. Visit www. Based on the information you provided, you do not appear to be eligible for Medicare cost-saving programs.

A trained counselor from the Medicare Rights Center will be in touch in the next 2 business days to discuss your options.