Costs
QMB billing protections: when providers can't bill you
If you're in the Qualified Medicare Beneficiary (QMB) program, doctors and other providers can't charge you Medicare deductibles, coinsurance or copays. How to prove it and what to do if you get a bill.
Checked against official sources on October 27, 2026 · How we check facts
The Qualified Medicare Beneficiary (QMB) program is the fullest of the Medicare Savings Programs. Your state pays your Medicare premiums and your share of Medicare costs. Federal law also protects you from being billed for those costs.
What providers can't bill you for
Medicare providers and suppliers, including pharmacies, can't bill you for Part A or Part B deductibles, coinsurance or copays on items and services Medicare covers. You can't choose to pay them, either. The protection applies:
- Whether you have Original Medicare or a Medicare Advantage plan.
- Even if the provider doesn't accept Medicaid, and even if Medicaid pays the provider nothing.
- Even if your QMB benefit comes from a different state than the one where you get care.
- On every date of service while you're in QMB.
You may still get a bill for a small Medicaid copayment, if your state has one. The protection covers drugs that Part B pays for, but not Part D prescriptions. Being in QMB qualifies you for Extra Help, which keeps Part D copays low.
Show that you're in QMB
Show your Medicare card and your Medicaid card (or QMB card) every time you get care. With Original Medicare, your Medicare Summary Notice also says you're in QMB and shouldn't be billed. If you sign up for electronic notices in your Medicare.gov account, you get an email each month your notice is ready instead of waiting for paper copies.
If you get a bill
- Tell the provider you're in QMB and show your cards. If you already paid for Medicare-covered care, you have the right to a refund.
- If the bills keep coming, call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). Medicare will confirm you're in QMB and can ask the provider to stop billing you and refund what you paid.
- If a debt collector keeps calling, file a complaint with the Consumer Financial Protection Bureau at consumerfinance.gov/complaint or 1-855-411-2372 (TTY 1-855-729-2372).
Keep your QMB active
The protection lasts only while you're in QMB. Your state checks your eligibility again from time to time, so answer renewal letters from your Medicaid office on time. To see who qualifies and how to apply where you live, find your state on our state pages.
Common questions
Can my doctor bill me if I'm in QMB?
No. Medicare providers can't bill people in the Qualified Medicare Beneficiary program for Medicare Part A or Part B deductibles, coinsurance or copays on covered care, and you can't choose to pay them.
What if my doctor doesn't take Medicaid?
The rule still applies. Every Original Medicare and Medicare Advantage provider must follow it, not only those that accept Medicaid, even if Medicaid pays them nothing.
Do I still pay at the pharmacy?
The QMB protection covers drugs Part B pays for, not Part D prescriptions. People in QMB get Extra Help, which keeps Part D copays low. You may also owe a small Medicaid copay if your state has one.
What do I do if I keep getting bills?
Show the provider your Medicare and Medicaid or QMB cards. If the bills continue, call 1-800-MEDICARE; Medicare can ask the provider to stop billing you and refund what you paid.
Sources
- Medicare.gov: 3 tips for people in the QMB program (fact sheet, May 2025)
- CMS: Prohibition on billing Qualified Medicare Beneficiaries (September 2025)
- Medicare.gov: Medicare Savings Programs
General information, not advice about a specific plan.