skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
Join eNews       En Español
Text Size:
YouTube LinkedIn Email Print
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 9/3/2022 Location: FL, PR, USVI Business: Part A, Part B

Why can’t I locate the deductible information when checking a patient’s eligibility?

If the beneficiary is enrolled as a Qualified Medicare Beneficiary (QMB), deductible information may not be available at the time of the query.
HETS (HIPAA Eligibility Transaction System) indicates periods during which the beneficiary is enrolled as a QMB, and will indicate the beneficiary owes $0 for Medicare Part A and B deductibles, coinsurance or copayments. Note: This information will be displayed under the QMB tab within SPOT.
QMB beneficiaries have no legal liability to pay Medicare providers for Medicare Part A or Part B cost-sharing. For these beneficiaries, providers may bill state Medicaid agencies which are responsible for covering Medicare cost-sharing, though the beneficiary may also have other secondary payers (e.g., VA, tribes, Medigap).
Please refer to MLN ICN 006977 external pdf file, SE1128 external pdf file, and MM9911 external pdf file for more information.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.