QMB in Maryland – such a mes.

Mostly a vent because it doesn’t seem like anyone has answers for how to navigate this better either at the state or local level or online.

My mom turned 65 this year and qualified for QMB – the state’s Medicaid program for folks over 65. This means she got dropped from her MCO (managed care provider), which is totally stupid logistically. Why would a poor old person be forced out of a system that’s limited but relatively straightforward into a more convoluted and impossible to use system?

Now, every time she wants to make an appointment, she has to explain that Medicare is her primary insurance, but QMB is her secondary. This leads her to be flat out rejected by most providers (and there is 0 way to screen who might accept it ahead of time). Some DO accept Medicaid but get confused because QMB is called “Qualified MEDICARE Beneficiary” so they assume it’s not Medicaid. But if you lead with saying she has Medicaid for secondary, they get confused when I explain she doesn’t have an MCO so I end up having to explain QMB anyway.

Just today, the billing department at an office where she has an appointment set said they checked her Medicaid number and it is inactive. This is blatantly inaccurate as I have her QMB acceptance letter in front of me with her Medicaid number and an expiration of 01/2023. Of course, the state of Maryland didn’t send a new Medicaid card (they don’t provide a good reason why) so this makes it even harder to argue with front desk staff who have no idea about QMB.

It’s just such a fucking headache. My mom speaks great English but she wasn’t born here and would have been even more lost if I wasn’t living with her and able to walk her through all of this. This is not how you should treat your most vulnerable population.