Health care costs for dual eligibles

The Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin concerning billing individuals who are eligible for both Medicare and Medicaid (dual eligibles) for health care costs not covered by either program.  The Qualified Medicare Beneficiary (QMB) is a Medicaid program that pays for Medicare premiums, deductibles and co-payments for individuals with low incomes.  Providers of Medicare services are prohibited from billing QMBs for deductibles, coinsurance, or copayments.

CMS released an Informational Bulletin concerning Section 3309 of the Affordable Care Act which eliminates Medicare Part D cost-sharing for full benefit dual eligible individuals receiving home and community-based services in lieu of institutional services.  Section 3309 became effective on January 1, 2012.

%d bloggers like this: