QMB

Medical abbreviation · Health Insurance

QMB
Stands forQualified Medicare Beneficiary
CategoriesMedical

QMB stands for Qualified Medicare Beneficiary, a health insurance abbreviation.

Medicare Savings Program for people with the lowest incomes that pays Medicare Part A and B premiums, deductibles, coinsurance and copays. Providers may not bill QMB enrollees for Medicare cost sharing.

Example: Patient is QMB; do not collect the Part B coinsurance at checkout.

Usage notes

Billing a QMB enrollee for Medicare cost sharing is prohibited even when Medicaid pays the provider little or nothing, a rule CMS has repeatedly reminded providers about. Medicare Summary Notices flag QMB status to help prevent improper bills. Pronounced as letters.

More health insurance abbreviations

  • PHI – Protected health information
  • PIP – Personal injury protection
  • PMPM – Per member per month
  • POS – Point of service (plan)
  • PPO – Preferred provider organization
  • QHP – Qualified health plan
  • QSEHRA – Qualified small employer health reimbursement arrangement
  • RAC – Recovery Audit Contractor
  • RAF – Risk adjustment factor
  • RVU – Relative value unit
  • SBC – Summary of benefits and coverage
  • SEP – Special enrollment period

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This entry is for general education and is not medical advice. Abbreviation use varies between institutions; always confirm in context.