Do not bill dual-eligible and QMB members with full Medicare benefits


If Medicare-Medicaid dual eligible individuals have their Part A and Part B cost-share fully covered by their Medicaid plan, or are Qualified Medicare Beneficiaries (QMBs), they are not responsible for their Medicare Advantage cost-share for covered services. Please do not balance bill these members for any other costs. If you received Medicare and Medicaid payments for services given to these members, it must be accepted as payment in full.