Why can't I see the deductible information for some patients when checking eligibility?


Answer: Maria Chechina, CPC, Billing Department Supervisor at WCH Service Bureau

I suppose the beneficiary is enrolled as a Qualified Medicare Beneficiary (QMB). In that case, deductible information may not be available at the query time.

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, the beneficiary may also have other secondary payers like VA, Medigap, etc.