0865.000.00 Qualified Medicare Beneficiaries (QMB)

0865.015.10 Payment of Medicare Coinsurance and Deductibles

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

Non-Medicaid 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 the Division of Medical Services in order to be paid as a provider of QMB services.