Qualified Medicare Beneficiary Program (QMB)
The Qualified Medicare Beneficiary (QMB) program is a Medicare Savings Program that, for beneficiaries with income and assets below its limits, pays Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. Providers generally may not bill QMB enrollees for Medicare cost-sharing.
Definition
The Qualified Medicare Beneficiary (QMB) program is a Medicare Savings Program that, for beneficiaries with income and assets below its limits, pays Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. Providers generally may not bill QMB enrollees for Medicare cost-sharing.
Why it matters
QMB status shifts cost-sharing away from the patient and carries balance-billing protections, so identifying it is important for both patients and billing.
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