Medicare Advantage and Qualified Medicare Beneficiary (QMB) Program
Posted on December 1, 2023
The Qualified Medicare Beneficiary (QMB) Program is one of the four Medicare Savings Programs that allows Enrollees to get help from the state to pay Medicare premiums and cost sharing. Some Health New England Medicare Advantage members have this benefit, and the Federal law prohibits Medicare providers from collecting coinsurance, copayments and deductibles from those enrolled in this program.
Recently, CMS has asked organizations to inform providers if the member cost-sharing liability is zero. We have done this by including an indicator in the eligibility screen on our provider portal. When you log in to check eligibility, you will now see whether the member is false or positive with a QMB status.
If you have questions or need assistance in locating this information, please call Provider Experience at (800) 842-4464, ext. 5000.
