0865.000.00 Qualified Medicare Beneficiaries (QMB)

0865.015.10 Payment of Medicare Coinsurance and Deductibles

IM-55 June 2, 2023

For individuals who are eligible for MO HealthNet (MHN), MO HealthNet Division (MHD) pays any coinsurance and deductibles for all Medicare services to MHN providers. The QMB program allows for the payment of these, but additionally, pays coinsurance and deductibles to enrolled non-MHN providers as long as the service is covered by Medicare.

Non-MHN provider types which are covered by Medicare include:

  • independent psychologists
  • chiropractors
  • independent physical therapists
  • independent occupational therapists

The providers of these services must agree to accept the QMB card as coverage of the coinsurance and deductible and need to make a minimal enrollment with MHD in order to be paid as a provider of QMB services.