WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #692
Qualified Medicare Beneficiary-Only Members
QMB-Only (Qualified Medicare Beneficiary-Only) members are a limited benefit category of Medicaid members. They are
eligible for coverage from Medicare (either Part A, Part B, or both) and limited coverage from Wisconsin Medicaid. QMB-Only
members receive Medicaid coverage for the following:
• Medicare monthly premiums for Part A, Part B, or both
• Coinsurance, copay, and deductible for Medicare-allowed services
QMB-Only members do not receive coverage from Wisconsin Medicaid for services not allowed by Medicare. Therefore,
Wisconsin Medicaid will not reimburse for services if either of the following occur:
• Medicare does not cover the service.
• The provider is not enrolled in Medicare.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
d822ec56331eebe8f5e99fa0a63f9c55b646fc186ff6630b4a1f33473648b262
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