TMPPM 2010 > Volume 1, General Information > Section 4: Client Eligibility > Medicare and Medicaid Dual Eligibility > Clients Without QMB/MQMB Status

4.9.3 Clients Without QMB/MQMB Status

Medicare is primary to Medicaid, and providers must bill Medicare first for their claims. Medicaid's responsibility for coinsurance and/or deductibles is determined in accordance with the Medicaid benefits and limitations including the 30-day spell of illness. TMHP denies claims if the client's coverage reflects Medicare Part A coverage and Medicare has not been billed first.

Providers must check the client's Medicare card for Part A coverage before billing Texas Medicaid.

Refer to: Subsection 2.6, "Medicare Crossover Reimbursement" in Section 2, Texas Medicaid Reimbursement (Vol. 1, General Information).