TMPPM 2008 > Provider Information > Client Eligibility > Restricted Medicaid Coverage

4.3.3 QMB, MQMB

The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria:

•Client is enrolled in Medicare Part A.

•Income does not exceed 100 percent of the FPL (consistent with federal law).

•Resources do not exceed twice the resource limit of Supplemental Security Income (SSI) Program.

Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits.

Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client.

QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition to Medicaid payment of Medicare deductible and/or coinsurance.

Refer to: "Medicare/Medicaid Clients" and "QMB/MQMB Clients" .