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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 102 – Non-Financial Requirements Page |113 Effective Month: September 2018 102.13 MEDICAID/MEDICARE REQUIREMENTS AND COORDINATION The following section describes basic information about Medicare and the coordination between the Division of Medicaid, the Social Security Administration (SSA) and the Centers for Medicare/Medicaid Services (CMS) in areas addressed below that include: • Basic Medicare entitlement information, • Medicare cost-sharing benefits payable for Medicaid recipients with Medicare, • The requirement under the Utilization of Other Benefits provision for who must apply and accept Medicare for individuals in all Medicaid covered COE’s, • Payment of Medicare premiums, referred to as Buy-In, and the Buy-In effective dates, • Medicare Part D information regarding pharmacy benefits under Part D, • SSA’s requirement to conduct outreach to certain low-income Medicare beneficiaries, and • Medicare Part C information regarding Medicare Advantage plans. 102.13.01 MEDICARE ENTITLEMENT – BASIC INFORMATION The chart on Medicare entitlement below is informational only. Certain conditions apply that are not shown. An application for Medicare filed with SSA is required in order to verify whether an applicant or recipient is eligible for Medicare, unless the individual has applied in the past and refused Medicare, withdrew from Medicare or lost Medicare due to non-payment of premium(s), which is discussed later in this section. NOTE: The Social Security Administration (SSA) is the federal agency that determines Medicare entitlement. The Center for Medicare/Medicaid Services (CMS) is the federal agency that funds Medicare and determines the coverage and benefits under Medicare.