Page 2117

West Virginia Income Maintenance Manual Chapter 25

West Virginia Income Maintenance Manual Page 4 Chapter 25 Medicaid Buy-In Procedures

SPECIAL PROCEDURES

In order for the Department of Human Services (DOHS) to buy-in for a client, the following conditions must be met: • He must be eligible for, and enrolled in, Medicare. • He must have an active case in the eligibility system. • His full name, birthdate, sex, and Social Security claim number (CAN) must match those shown on the Master Beneficiary Records, received by the Buy-In Unit.

The Worker has no responsibility other than acting as requested by the Medicare Buy-In Unit. 25.3.2.A SSA Responsibilities The Social Security Administration (SSA) is responsible for enrolling Supplemental Security Income (SSI) recipients who qualify for Medicare. The Centers for Medicare and Medicaid Services (CMS) provides information about these SSI recipients to the DOHS on a monthly Master Buy-In file. 25.3.2.B Termination of Buy-In Note: If a worker identifies an SSI recipient who is entitled to premium-free Medicare Part A and/or enrolled in Medicare Part B, and not receiving QMB, they must open the QMB coverage. An SSI recipient is deemed eligible for QMB coverage the first day of the month following the month they are determined eligible for QMB.

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Page 2117

Official source

West Virginia Income Maintenance Manual Chapter 25

West Virginia Income Maintenance Manual Page 4 Chapter 25 Medicaid Buy-In Procedures

SPECIAL PROCEDURES

In order for the Department of Human Services (DOHS) to buy-in for a client, the following conditions must be met: • He must be eligible for, and enrolled in, Medicare. • He must have an active case in the eligibility system. • His full name, birthdate, sex, and Social Security claim number (CAN) must match those shown on the Master Beneficiary Records, received by the Buy-In Unit.

The Worker has no responsibility other than acting as requested by the Medicare Buy-In Unit. 25.3.2.A SSA Responsibilities The Social Security Administration (SSA) is responsible for enrolling Supplemental Security Income (SSI) recipients who qualify for Medicare. The Centers for Medicare and Medicaid Services (CMS) provides information about these SSI recipients to the DOHS on a monthly Master Buy-In file. 25.3.2.B Termination of Buy-In Note: If a worker identifies an SSI recipient who is entitled to premium-free Medicare Part A and/or enrolled in Medicare Part B, and not receiving QMB, they must open the QMB coverage. An SSI recipient is deemed eligible for QMB coverage the first day of the month following the month they are determined eligible for QMB.