ESRD cases are processed for State buy-in as any other Medicare case.
If a State will pay the SMI premiums under buy-in beginning with the first month of
R-HI entitlement, there is no need to discuss alternate choices of a SMI entitlement
date as in HI 00801.251 B.
If an alternate date to begin R-SMI has been elected, and that date is later than
the first month that buy-in is effective, the individual's choice will not be honored.
If the buy-in is for a closed period that ends 6 or more months prior to the month
of processing, or if there are months of coverage that could be in effect prior to
the effective month of buy-in, the individual will have the options in HI 00805.195 G.