Program Operations Manual System (POMS)
HI 00815.055 Establishing State Buy-In Eligibility for Railroad Retirement Board (RRB) Annuitants
Medicare Entitlement can be established under the Railroad Retirement Act as it is
under the Social Security Act.
The RRB maintains a master eligibility file of all qualified RRB Annuitants which
is equivalent to Social Security Administration's (SSA’s) Master Beneficiary Record
(MBR) File. When RRB establishes Medicare for an annuitant, a record is generated
to SSA for inclusion in the MBR file even though RRB maintains jurisdiction of the
record. This situation also applies to those cases where dual entitlement (RRB Annuitant
and SSA Title II Benefit) is involved - RRB maintains jurisdiction for Medicare eligibility.
When a Social Security Income (SSI) claim is being filed, the District Office (DO)/Branch
Office (BO) should query the MBR file to determine whether Medicare entitlement exists
or does not exist.
MBR - Medicare Entitlement Present - Proceed in developing the SSI claim for the beneficiary and follow instructions
in item C below.
MBR - Medicare Entitlement Not Present or Record Not In File (NIF) - If it appears that the SSI applicant may also be eligible for Medicare the DO/BO
should complete the exhibit in HI 00815.208 (Reproduce/copy the exhibit as needed) and proceed in developing the SSI claim, then
follow the procedures in item C below.
Inform the beneficiary that, if they are eligible for Medicare, they may also be eligible
for Medicare Part B under the State Buy-in Provision (see chart in HI 00815.009) and if so, their state of residence will pay the Medicare Part B monthly premium
for them. Advise the beneficiary that it may take up to 3 or 4 months for all of the
records to be established. The Buy-in determination will be made at that time. This
activity does not have any effect on their SSI application.
Individual complaints from RRB annuitants concerning their buy-in status should be
processed the same as any other buy-in complaint case (see HI 00815.070 through HI 00815.094 for problem case procedures). Do not send RRB Buy-in problem cases to the RRB.
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HI 00815.055 - Establishing State Buy-In Eligibility for Railroad Retirement Board (RRB) Annuitants - 06/10/2015
Batch run: 06/10/2015