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Aged, Blind and Disabled Manual Section: Medicare Savings Programs Policy Manual Number: 120.005 Chapter: Medicare Savings Programs Overview

March 1, 2024 Division of TennCare 4

The Social Security Administration (SSA) transmits LIS files to the State daily, which triggera review for MSP eligibility.

The MSP application date is the date the LIS application is filed with SSA. If an LIS application is approved for SLMB or QI1, the benefits will begin the date the LIS application was filed at the SSA office. If approved for QMB, the benefits will begin the month after the approval is authorized.

b. TennCare’s Medicare Buy-In Unit

For applicants and enrollees who must have Medicare Part A or B established by the state, the Medicare Buy-In Unit is responsible for notifying CMS and/or SSA to begin coverage. The Buy- In Unit sends a manual notification to CMS to begin Medicare in the following situations:

• An applicant is approved for QMB, SLMB, or QI1 and needs to be enrolled in Medicare Part B; • An SSI-recipient has reached aged 65 and must have Medicare Part A established. (The SSA establishes Medicare Part B.); • An applicant is approved for QMB and is enrolled in Medicare Part B, but must have Medicare Part A established; • An applicant already has active Part B enrollment, needs to have Part A enrollment started with a Part A buy-in, and is eligible for QMB and/or SSI; • An applicant is already actively enrolled in both Parts A and B, is approved for QMB and/or SSI, Part A is not free, and the applicant needs to have a Part A buy-in set up so the state can take over payment of Part A premiums; • An applicant is already actively enrolled in both Parts A and B, does not have free Part A, is approved for QMB and/or SSI, and has buy-in(s) for one or both parts from another state which are either still active or recently closed.