The QMB program provides Medicaid payment of Medicare premiums, and coinsurance and deductibles for all Medicare services.

QMB does NOT provide Medicaid coverage for services not covered by Medicare.

0865.015.05 Buy-in for QMB

IM-#5 January 20, 2012

Under the QMB program, the state pays the recipient's Medicare premiums, both Part A (if a premium payer) and Part B. Part B premiums are paid through the Buy-In system. The MO HealthNet Division (MHD) Buy-In Unit handles payment of Part A premiums through a separate process.

All buy-in related issues for Missouri participants should be sent to the Medicare Buy-In Unit’s email address.  This email address is MHD.Buyin@dss.mo.gov.

The purpose of this email address is to provide a centralized location for Eligibility Specialists, Supervisors, County Managers, other FSD employees, MHD employees, etc., to send their emails to when someone’s buy-in needs to be started, restarted, checked, or ended.

0865.015.10 Payment of Medicare Coinsurance and Deductibles

For individuals who are Medicaid eligible, Medicaid pays any coinsurance and deductibles for all Medicare services to Medicaid providers. The QMB program allows for the payment of these, but additionally, pays coinsurance and deductibles to enrolled non-Medicaid providers as long as the service is covered by Medicare.

Non-Medicaid provider types which are covered by Medicare include:

The providers of these services must agree to accept the QMB card as coverage of the coinsurance and deductible and need to make a minimal enrollment with the Division of Medical Services in order to be paid as a provider of QMB services.

0865.015.15 Services not covered under QMB

QMB-only recipients will not have Medicaid coverage for services not covered by Medicare. Not covered are:

If the worker cannot determine whether a service is covered under the QMB program, the worker may call the Division of Medical Services' Provider Relations Unit at the following telephone number: 573-751-2896. This number is not for the use of the client.