When an individual is admitted to the nursing home and is receiving coverage through the Medicare Savings program only, a new application and verifications are required. The Medicare Savings program assists with Medicare out of pocket expenses only, it is not Medicaid. There are two types of Medicare Savings Plans, Qualified Medicare Beneficiary (QMB) and Low Income Medicare Beneficiary (LMB). QMB covers the Part B premium, co-pays and deductibles. LMB covers the Part B premium.
An individual receiving assistance through the Medicare Savings program (QMB or LMB) does not receive a KanCare card and is not assigned to an MCO. When a provider is verifying eligibility in KMAP, it will return QMB as a benefit plan for an individual who is QMB only. For LMB, it will return Medicare information but no eligibility information for a LMB only. If the provider does not see Medicaid eligibility in KMAP, proceed with completion of an application.
