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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 102 – Non-Financial Requirements Page |120 Effective Month: September 2018 102.13.04 DUAL ELIGIBILITY AND THE BUY-IN EFFECTIVE DATE A Medicaid recipient with Medicare data on file is assigned a Dual Eligibility Indicator (DEI), which is used along with the disposition date of an application to determine the Buy-In effective date. This is the date Medicaid will begin payment of the recipient’s Part B premium and/or Part A premium, if applicable. Recipients with full Medicaid/Medicare are fully dual; recipients in a Medicare cost-sharing group are partial duals since there is no full Medicaid eligibility for a QMB, SLMB or QI. Both full and partial duals are entitled to all of the benefits of the Low-Income Subsidy, described in 102.13.05 below. NOTE: The DEI is located on the Eligibility History screen in the MMIS in the column entitled “Dual Elig.” QMB Duals and QMB-Only – DEI is “Q” Recipients with Medicare and full Medicaid who have income at or below 100% FPL are QMB duals. Recipients in COE-031 are QMB-only eligible. Refer to 400.05.02 for a discussion of QMB dual eligibility. The Buy-In effective date for both Part A and Part B is the month after the month of disposition of the application for both QMB-only and QMB-dual recipients. • Example: A QMB-only approved in August has a buy-in effective date of September. A QMB-dual nursing home applicant approved in October has a buy-in effective date of November. If the same nursing home applicant approved in October did not get Medicare entitlement until December, the Buy-In effective date is December because the month after the month of disposition would have been met. • It is not appropriate to place a QMB into a SLMB or QI COE in order to get retroactive payment of Part A/B. If, however, a QMB application is not approved timely due to agency error, the QMB-override function in MEDS can override the beginning date of QMB eligibility.