If Medicare-Medicaid dual eligible individuals have their Part A and Part B cost-share fully covered by their Medicaid plan or are Qualified Medicare Beneficiaries (QMB), they are not responsible for their Medicare Advantage cost-share for covered services. Do not balance bill these members for any other costs. Any Medicare and Medicaid payments for services given to these members must be accepted as payment in full.
For EmblemHealth members, you can use ePaces to check whether the member has full or partial Medicaid benefits. For more detail, see EmblemHealth Medicare Advantage Plans.
For ConnectiCare members, visit CT Department of Social Services or call 800-842-8440. For more detail, see ConnectiCare Medicare Advantage Plans.
JP 61585 03/2023