State Medicaid programs now pay Medicare premiums, deductibles and co-insurance for Medicare recipients with limited income and resources. These individuals are called Qualified Medicare Beneficiaries (QMB).
Medicaid Will Pay:
- Monthly PREMIUMS for Medicare Part B.
- Medicare DEDUCTIBLES (the yearly deductible for Part B Medicare services such as office visits, lab, X-ray services and the Part A deductible if you are hospitalized)
- Medicare CO-INSURANCE (the 20% per service charge which you have to pay for most medical services)
Medicaid will only pay for medical services that are benefits of Medicare. PRESCRIPTIONS ARE NOT A BENEFIT OF THE QMB PROGRAM.
The QMB recipient must show the medical provider his/her Medicare card and his/her Medicaid card.
Medicaid and Medicare combined, will automatically pay for monthly premiums, co- insurance and deductibles of any medicare service.
Medicaid coverage will begin the month after the application is approved by the county.
NOTE: When you are approved for QMB, it will take about 90 days for payments to be made. You will be reimbursed for any Medicare premiums you made during that period.
To Check Your Medical Assistance Application Status
Coloradans can check the status of their Medical Assistance Application (includes Medicaid and Child Health Plan Plus (CHP +)) by calling 1-800-359-1991 between 8:00am and 6:00pm Monday-Friday (closed for State holiday). Applicants will need their Application Tracking Number, found on the final screen of the online application when they call.
To Qualify for QMB you must:
- BE CURRENTLY ELIGIBLE FOR MEDICARE "HOSPITAL INSURANCE" (PART A)
- Individuals who have income at or below the percentage of federal poverty level for the family size as mandated by federal regulations.
- NOTE: QMB income limits change each year based on federal guidelines. Contact the Mesa County Department of Human Services for more information.
- Income is anything which can be used to purchase food, clothing or shelter. Some examples include wages, social security, pensions, child support and unemployment benefits.
- HAVE RESOURCES BELOW $8,100 FOR INDIVIDUALS AND $12,910 FOR COUPLES, (Resources are whatever money remains unspent from a prior month. Some examples include cash, checking and savings accounts, stocks, bonds, some insurance policies and secondary property.)
- Note: The home, a car, personal belongings, household goods, some burial polices, and some life insurance policies are EXEMPT. They are NOT COUNTED as part of your resources.
- BE A U.S. CITIZEN OR PERMANENT LEGAL ALIEN, AND
- BE A RESIDENT OF COLORADO
Documents To Bring
- You must fill out a written application. A technician will help you complete the application and tell you of any additional documents that are needed.
- Do Not Wait To Apply! Set an appointment today. Bring as many documents as possible. If you do not have all of your paperwork in order, you can gather it after the first interview.
- Proof Of Age (such as):
- Birth certificate or
- Baptismal certificate
- Proof Of Colorado Residency (such as):
- Self-written statement testifying you are a resident of Colorado or
- Any photo I.D. with your address or
- A copy of your telephone bill
- Proof Of Resources (all of these):
- Bank statements
- Registration papers for motor vehicles
- Deed and mortgages for real property
- Life insurance policies
- Burial funds or policies
- Proof Of U.S. Citizenship (such as):
- Birth certificate or
- Citizenship records or
- Social Security card
- Proof Of Your Income and Your Spouse's Income (all of these):
- Payroll stubs
- Verification of Social Security and SSI
- Proof of other income or checks you receive
- Proof Of Medicare "Part A" Eligibility