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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 4: Client Eligibility : 4.11 Medicare and Medicaid Dual Eligibility

4.11 Medicare and Medicaid Dual Eligibility
MQMB clients are eligible for Medicaid benefits not covered by Medicare in addition to Medicaid payment of the Medicare deductible and/or coinsurance.
QMB clients are not eligible for Medicaid benefits other than the Medicare deductible and coinsurance liabilities and payment of the Medicare Part B premium. Certain clients also receive payment of Medicare Part A premium. Clients limited to QMB are not eligible for THSteps or CCP Medicaid benefits.
These guidelines exclude clients living in a nursing facility who receive a vendor rate for client care through DADS.
Refer to:
Section 6: Claims Filing (Vol. 1, General Information) for more information about filing claims for MQMBs and QMBs.

Texas Medicaid & Healthcare Partnership
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