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QMB Dual definition

QMB Dual means a person determined eligible under Article 2 of this Chapter for Qualified Medicare Beneficiary (QMB) and eligible for Acute Care services provided for in 9 A.A.C. 22 or ALTCS services provided for in 9 A.A.C. 28. A QMB Dual person receives both Medicare and Medicaid services and cost sharing assistance. For the purpose of Article 2 of this Chapter, QMB includes members defined in A.R.S. § 36-2971(5).
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QMB Dual means a person determined eligible under Article 2 of this Chapter for Qualified Medicare
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Examples of QMB Dual in a sentence

  • A QMB+ Dual Eligible Member has no legal obligation to make further payment to a provider or to the MAO for Medicare Part A or Part B cost sharing amounts.

  • Dual eligibles include, but are not limited to, persons who are referred to as QMB Only, QMB Dual, SLMB, QI 1, Acute Care Duals and ALTCS Duals.

  • Section 1902(n)(3)(B) of the Social Security Act prohibits a Medicare provider from balance billing a QMB+ Dual Eligible Member for Medicare cost sharing amounts, including deductibles, coinsurance, and copayments.

  • For a QMB+ Dual Eligible Member, AHCCCS shall provide payment of the applicable Medicare Part A premium, the applicable Medicare Part B premium, Medicare coinsurance amounts, and Medicare deductibles for Medicare covered services.

  • The Administration pays Medicare part A and B premiums for a QMB Dual member enrolled with a contractor in a plan or AHCCCS Fee-For-Service.

  • A QMB Dual person receives both Medicare and Medicaid services and cost sharing assistance to help pay Medicare Part A and Part B premiums, and other cost sharing (like deductibles, coinsurance, and copayments).

  • For QMB Dual members/services, Health Choice Arizona will reimburse the member’s cost share as reported by Medicare.

  • If a Medicare provider determines that a covered service is medically necessary, the Contractor is responsible for Medicare cost sharing amounts if the member is a QMB Dual, even if the Contractor determines the covered service is not medically necessary.

  • For a QMB Dual and a Non-QMB Duals, Federal and State laws prohibit the use of AHCCCS moniesTitle XIX or Title XXI funds to pay for Medicare cost sharing amounts related toof Medicare Part D prescription drug benefit medications.

  • For a QMB Dual and a Non-QMB Dual, Federal and State laws prohibit the use of Title XIX or Title XXI funds to pay Medicare cost sharing amounts related to Medicare Part D prescription drug benefit medications.

Related to QMB Dual

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  • Derivative Provider Trigger Event means (i) an Event of Default with respect to which Party A is a Defaulting Party, (ii) a Termination Event with respect to which Party A is the sole Affected Party or (iii) an Additional Termination Event with respect to which Party A is the sole Affected Party.

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  • R E C I T A L S The parties desire to enter into this Agreement setting forth the terms and conditions of the employment relationship between the Corporation and the Executive.

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  • Class A-1 Pass-Through Rate With respect to any Distribution Date, a per annum rate equal to 2.0020%.

  • Intermediate Distribution Frame (IDF) means a second frame that augments an existing Main Distribution Frame. Lines or outside cables that do not terminate on the IDF.

  • Class A-4 Pass-Through Rate With respect to any Distribution Date, a per annum rate equal to 3.469%.

  • Class C Pass-Through Rate For any Distribution Date, a per annum rate equal to the WAC Rate for such Distribution Date.

  • Class A-3 Pass-Through Rate For any Distribution Date, a per annum rate equal to 3.356%.

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  • Class X-B Pass-Through Rate For any Distribution Date, the weighted average of the Class X Strip Rates for the Class X-B Components for such Distribution Date (weighted on the basis of the respective Component Notional Amounts of such Components outstanding immediately prior to such Distribution Date).

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Most Referenced Clauses

Most Referenced Definitions