A person who qualifies for Medicare benefits due to his or her income being under the federal poverty guidelines.
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qualified Medicare beneficiary (QMB)
Medicaid program for beneficiaries who need help in paying for Medicare services. The beneficiary must have Medicare Part A and limited income and resources. For those who qualify, the Medicaid program pays Medicare Part A premiums, Part B premiums, and Medicare deductibles and coinsurance amounts for Medicare services.
Qualified pension plan
Retirement plan that conforms to the regulations contained in Section 401(a) of the Internal Revenue Code. It is established and maintained by an employer to provide for benefits to employees over a period of years after retirement. Qualified plans are approved by the Internal Revenue Service. The employer’s contributions are considered a deduction in determining the employer’s taxable income, not considered as employee earnings, and not taxable to the employee. Earnings of the pension plan are not subject to income tax.
Qualified peril
Peril that has to be interpreted against the backdrop of qualifying words. The insured must show that his loss was caused by the peril as qualified. The standard fire policy contains qualified perils – fire is covered only if not occasioned by or happening through, riot and civil commotion. An insured must therefore show that his fire damage was ‘fire damage not caused by riot or civil commotion’. See ONUS OF PROOF.
Qualified plan (Pensions)
An IRS-approved retirement plan. These plans have do not discriminate as to who can participate, and are tax deductible for the contributer, which is usually the employer.
qualified rehabilitation representative (QRR)
In workers’ compensation, a trained rehabilitation consultant who meets established criteria to administer vocational rehabilitation counseling and benefits to employees who have been injured at work.
Qualified sick-pay plan
Type of disability income insurance that gives benefits to employees when they are unable to work because of injury or illness that is not work related.
Qualifying circumstances
Particularly difficult situations such as extreme age, complication of total body hypothermia, controlled hypotension, or emergency condition for which a CPT add-on code (99100, 99116, 99135, or 99140) is used when an anesthesia service is provided.
Qualifying event
An event that allows an insured to change the terms of his or her coverage outside of the normal open enrollment period. Examples include the birth of child, a marriage, or a divorce.
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An occurrence that triggers an insured’s protection.
Qualifying event (Health Insurance)
An event that causes the insured’s coverage; for example, a death, birth, or job loss.