HI 00815.003 State Buy-In Coverage Groups

A. General

State Buy-In coverage groups include all beneficiaries eligible for Medicare Part B (also known as Supplementary Medical Insurance (SMI)) enrollment who are receiving or are eligible for a category of assistance under Medicaid as specified in the State's buy-in agreement or are reported by the State to be a member of its coverage group.

B. Effect of the Supplemental Security Income (SSI) Program on Coverage Groups

The Supplemental Security Income (SSI) program (also known as Title XVI), which became effective January 1, 1974, replaced the State administered Titles I, X, XIV, and XVI (aid to the blind and disabled) which formed the basis for State Buy-In coverage groups between 7 /1/1966 and 12/31/1973. The federally administered Title XVI (SSI) is effective in the District of Columbia, the Northern Mariana Islands and the 50 States. The State-administered Titles I, X and XIV remain in effect in Puerto Rico, Guam and the Virgin Islands.

C. Coverage Groups Effective 1/1/1974

  1. Beneficiaries receiving Supplemental Security Income (SSI) under Title XVI or a State Supplement (whether or not federally administered) who are categorically needy under the plan of the State approved under Title XIX (Medicaid).

  2. Beneficiaries receiving Supplemental Security Income (SSI) under Title XVI, a State Supplement (whether or not federally administered) or money payments under a plan of the State approved under Part A of Title IV (Aid to Families with Dependent Children (AFDC)) who are categorically needy under the plan of the State approved under Title XIX (Medicaid).

  3. Beneficiaries eligible for medical assistance under a plan of the State approved under Title XIX (Medicaid).


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HI 00815.003 - State Buy-In Coverage Groups - 04/01/2015
Batch run: 04/01/2015
Rev:04/01/2015