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AHCCCS
Medicare Cost-Sharing Programs
The QMB (Qualified Medicare Beneficiary)program provides medical assistance including payment of a member's Medicare Part B premium, annual deductibles, and co-insurance, up
to and including acute care medical services through an AHCCCS health plan.
Members may qualify for this program if they meet non-financial guidelines, have Medicare Part A, and meet the income guidelines.
Effective April 1, 2011, an applicant may be eligible if the total gross monthly income (after a $20 disregard) is less than $908.00 (for a single person) or less than $1226.00 (for a married couple).
Members may choose to be QMB qualified only which means that they do not have to use a Medicaid (AHCCCS) provider. Their QMB benefits will work similarly to a Medigap insurance policy
when providers accept Medicare assignment. For example, if a person goes to the doctor and the doctor accepts Medicare assignment, Medicare will pay 80% and QMB will pay 20%. If, however, a
person goes to a provider that does not accept Medicare assignment, then Medicare will pay 80% of the assignment amount and QMB will pay 20% of the Medicare assignment amount.
The difference will have to be paid by the member through their own funds.
If a member chooses to enroll in AHCCCS and in an AHCCCS Health Plan, then members will need to use AHCCCS-contracted providers to reduce their overall medical costs.
The SLMB (Specified Low-Income Medicare Beneficiary)program provides medical assistance by paying for a member's Medicare Part B premium.
Members may qualify for this program if they meet non-financial guidelines, have Medicare Part A, and meet the income guidelines.
Effective April 1, 2011, an applicant may be eligible if the total gross monthly income (after a $20 disregard) is between $908.01-$1089.00 (for a single person) or
$1226.01-$1471.00 (for a married couple).
The QI-1 (Qualified Individual One) program provides medical assistance by paying for a member's Medicare Part B premium.
Members may qualify for this program if they meet non-financial guidelines, have Medicare Part A, and meet the income guidelines.
Effective April 1, 2011, an applicant may be eligible if the total gross monthly income (after a $20 disregard) is between $1089.01-$1226.00 (for a single person)
or $1471.01-$1655.00 (for a married couple).
Please contact me about these services . . .
ALTCS Planning.net is not affliated with AHCCCS / ALTCS / VA. ALTCS Planning.net is a private consulting firm.
If you would like to schedule an appointment or would like to submit a question or a comment, please use the form below. We respond to all inquiries within one business day.
ALTCS Planning.net is not affiliated with AHCCCS / ALTCS / VA.
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The information on this website is provided "as is" for general information purposes only. The content of this website may not be comprehensive, up-to-date, or applicable in all jursdictions. The content may not reflect the views of Montgomery & Associates, Inc. (DBA: ALTCS Planning.net) and Montgomery & Associates, Inc. (DBA: ALTCS Planning.net) makes no warranty of any kind, whether express or implied, with respect to any information provided on this website. Montgomery & Associates, Inc. (DBA: ALTCS Planning.net) assumes no liability for any errors or omissions in the content on this website and the information provided is not to be construed as legal advice. The information is intended to provide a general, factual overview of legal documents and planning options available. For legal matters you should always seek counsel of a qualified attorney licensed in your jurisdiction. Use of any information on this website is at your own risk.
**IMPORTANT NOTICE**
Our CLDP, Carol Aragon-Montgomery, prepares legal documents.OUR CLDP IS NOT AN ATTORNEY AT LAW AND IS NOT EMPLOYED BY ATTORNEYS AT LAW AND CANNOT GIVE LEGAL ADVICE.Your communications with our CLDP are kept CONFIDENTIAL by our CLDP, but since our CLDP is not an attorney at law, such communications are NOT PRIVILEGED (i.e., immune from Subpoena). Our CLDP can give you general factual information pertaining to legal rights, procedures, or options available to you in a legal matter when you are not represented by an attorney.Our CLDP cannot give you specific legal advice, opinions, or recommendations about your legal rights, remedies, defenses, options, or strategies. Please note that the Long Term Care Planning Services are of a financial planning nature and are not specific "legal" advice. Prices subject to change without notice.
