QMB Plus means a QMB who also meets the financial criteria for full Medicaid coverage. QMB Plus individuals are entitled to QMB Medical Benefits, plus all benefits available under the Texas State Plan for fully eligible Medicaid recipients. Qualifying Individual (QI) means an individual who is entitled to Medicare Part A, meets federal income and resource criteria, and who is not otherwise eligible for Medicaid. A QI is eligible only for Medicaid payment of Medicare Part B premiums. Specified Low-income Medicare Beneficiary (SLMB) means in individual who is entitled to Medicare Part A, and meets federal income and resource criteria. A SLMB is eligible for payment of Medicaid payment of Medicare Part B premiums. Categories of SLMBs are:
QMB Plus means a QMB who also meets the financial criteria for full Medicaid coverage. QMB Plus individuals are entitled to QMB Medical Benefits, plus all benefits available under the Texas State Plan for fully eligible Medicaid recipients. Specified Low-income Medicare Beneficiary (SLMB) means in individual who is entitled to Medicare Part A and meets federal income and resource criteria. A SLMB is eligible for payment of Medicaid payment of Medicare Part B premiums. Categories of SLMBs are:
QMB Plus is an individual who meets all of the Qualified Medicare Beneficiary (QMB) eligibility requirements and who also meets the criteria for full Medicaid benefits under New York’s Medicaid Plan.
Examples of QMB Plus in a sentence
Members For purposes of this Agreement, High Risk Dual Eligible Members are limited to the following categories of recipients: QMB Plus and SLMB Plus.
More Definitions of QMB Plus
QMB Plus means a QMB who also meets the financial criteria for full Medicaid coverage. QMB Plus individuals are entitled to QMB Medical Benefits, plus all benefits available under the Texas State Plan for fully eligible Medicaid recipients. Qualifying Individual (QI) means an individual who is entitled to Medicare Part A, meets federal income and resource criteria, and who is not otherwise eligible for Medicaid. A QI is eligible only for Medicaid payment of Medicare Part B premiums. Upon execution of this Agreement, the MA Dual SNP must provide HHSC with a copy of the MA Agreement and all attachments. The MA Dual SNP must provide HHSC with the actuarial value for Medicare Cost Sharing Obligations for the projection period consistent with the CMS bid submission. The MA Dual SNP agrees to provide HHSC a summary of its benefit designs for Dual Eligible Members and Other Dual SNP Members as well as financial data in a set format that allows HHSC, in HHSC’s sole determination, to determine the cost of services and utilization experience to calculate the PMPM rates. In addition, the MA Dual SNP must also provide all amendments to the MA Agreement or the Bid Pricing Tool to HHSC within fifteen (15) business days of receiving a request for this information.
QMB Plus means a QMB who also meets the financial criteria for full Medicaid coverage. QMB Plus individuals are entitled to QMB Medical Benefits, plus all benefits available under the Texas State Plan for fully eligible Medicaid recipients. Qualifying Individual (QI) means an individual who is entitled to Medicare Part A, meets federal income and resource criteria, and who is not otherwise eligible for Medicaid. A QI is eligible only for Medicaid payment of Medicare Part B premiums. DocuSign Envelope ID: Specified Low-income Medicare Beneficiary (SLMB) means in individual who is entitled to Medicare Part A, and meets federal income and resource criteria. A SLMB is eligible for payment of Medicaid payment of Medicare Part B premiums. Categories of SLMBs are: