FBDE definition

FBDE means full benefit dual-eligible members who are eligible to have full Medicaid benefits (SLMB+ and QMB+).
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FBDE is an individual who is eligible for full Medicaid benefits under the Medicaid State Plan because the individual falls within a federal mandatory coverage group or an optional coverage group (such as medically needy) but who does not meet the income or resource criteria for QMB or SLMB. Under the Medicaid State Plan, FBDEs are eligible for some financial assistance from the Agency in connection with Medicare Part A premiums, and in some cases Medicare Part B premiums. Medicare cost-sharing obligations may effectively be covered by the State Medicaid benefit, but certain conditions must be met, including 1) the service is also covered by Medicaid, 2) the provider is also a Medicaid provider, and 3) the Medicaid fee schedule amount is greater than the Medicare amount paid.
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Examples of FBDE in a sentence

  • Prescription drugs and drug classes covered by Medicare Part D for FBDE Members are not a Covered Service.

  • These individuals are considered to be Full Benefit Dual Eligible Members, and include Qualified Medicare Beneficiary Plus (QMB Plus), Specified Low-Income Medicare Beneficiary Plus (SLMB Plus) and Other Full Benefit Dual Eligible (Other FBDE) populations.

  • Make clear that SLMB+ and Other FBDE enrollees will not be held liable for cost-sharing amounts associated with Medicare A and B services rendered by the MA Health Plan’s network providers if the services are also covered under Rhode Island’s Medicaid state plan.

  • To ensure FBDE Members receive appropriate medications necessary for treatment of physical or Behavioral Health conditions, Contractor shall coordinate with FBDE Members MA and Dual Special Needs Plans or Part D Plans to ensure Members are connected to Medicare medication management services.

  • For services rendered to the MA Health Plan’s SLMB+ and Other FBDE enrollees, contracted providers will: (1) accept the MA Health Plan’s Medicare reimbursement as payment in full or bill Rhode Island Medicaid for services that are covered under Rhode Island’s Medicaid state plan or a Rhode Island Medicaid waiver, and (2) refrain from collecting cost sharing from SLMB+ and Other FBDE enrollees for those services.

  • Upon implementation of the data interface as specified in Section A.2.c.3., TennCare will provide each FBDE member’s TennCare MCO enrollment information via the data interface.

  • These individuals are considered to be Full Benefit Dual Eligible Members, and include Qualified Medicare Beneficiary Plus (QMB+), Specified Low-Income Medicare Beneficiary Plus (SLMB+) and Other Full Benefit Dual Eligible (Other FBDE) populations.

  • Indicate that SLMB+ and Other FBDE enrollees may be charged cost-sharing amounts if they: (1) see a provider who is not part of the MA Health Plan’s D- SNP network or a registered Medicaid provider in Rhode Island and/or (2) obtain services that are not covered under Rhode Island’s state plan or a Rhode Island Medicaid waiver.

  • TennCare shall provide the Contractor with the contact information of a FBDE member’s MCO as requested by the Contractor.

  • Accepting and processing in a timely manner referrals for case management and/or disease management from a FBDE member’s MCO, including a CHOICES member’s TennCare MCO Care Coordinator.

Related to FBDE

  • Façade means the principal front or fronts of a building.

  • Embalmer means any person engaged in the practice of embalming.

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  • Pioneer or the "Company" means Pioneer Natural Resources Company and its subsidiaries.

  • Sternlight means a white light placed as nearly as practicable at the stern showing an unbroken light over an arc of the horizon of 135 degrees and so fixed as to show the light 67.5 degrees from right aft on each side of the vessel.