Qualified Medicare Beneficiary (QMB) Only

AHCCCS QMB – ONLY (Health Program ID #008715)

This Medicare Savings Program pays the member’s Medicare part A premium (when applicable), Medicare Part B premiums, Medicare (or Medicare HMO) Co-Insurance and Medicare Deductibles, and Medicare Copays.

Qualifications

• Receiving or eligible for Medicare Part A
• Must be an Arizona resident
• Must be a U.S. Citizen or Medicaid eligible non-citizen
• Must apply for pension, disability or retirement benefit, if available
• Income equal to or less than 100% of the Federal Poverty Level

AHCCCS QMB – ONLY is Medicare Savings Program that pays Medicare Part A premium (when applicable) and Medicare Part B premium. Claim payments are limited to Medicare deductible, coinsurance, and copay when Medicare pays first. Claims are normally crossed over by Medicare to the AHCCCS Administration. Claims may be directly submitted to the AHCCCS Administration from registered AHCCCS providers with a matching EOMB.

For more information, see Payment of Medicare Cost Sharing for Qualified Medicare Beneficiaries (QMBs). For questions regarding Medicare coverage, call 1-800-MEDICARE.