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. 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 for more information.