QMB, or Qualified Medicare Beneficiary, mainly pays Medicare cost-sharing , not full Medicaid benefits. It typically covers Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments for covered Medicare services.

Quick Scoop

Under QMB, Medicaid pays for:

  • Part A premiums if you have them.
  • Part B premiums and the Part B deductible.
  • Coinsurance and copayments for Medicare-covered Part A and Part B services.

What it does not pay

  • Medigap premiums are not covered.
  • QMB is not usually a full Medicaid plan; it mainly helps with Medicare out-of-pocket costs.

Practical effect

If you have QMB, providers generally should not bill you for Medicare- covered cost-sharing. If you want, I can also give you a simple list of what QMB covers vs. what regular Medicaid covers.