For the SSI auto-accrete process to occur, the SSI eligibility data (title XVI) and
the Medicare eligibility data (title XVIII) must both be present on the MBR. The Social
Security DO/BO can determine whether entitlement to Medicare Part B has been established
by querying the MBR.
When an SSI applicant in an auto-accrete State appears to meet the basic Medicare
eligibility and Medicare entitlement is not present on the MBR, obtain a title XVIII
application. Obtain the application even if the individual refuses Medicare coverage
unless the State buys-in for him.
If the DO/BO does not obtain a title XVIII application at the same time the SSI application
is taken, SSA’s Office of Systems will release a leads claims package to the servicing
DO/BO for development (See HI 00810.010 for developing entitlement to Medicare.)
Additionally, SSA’s Office of Systems (OS) reviews the SSR each month to locate blind
or disabled SSI recipients who are age 64 years and 9 months or older, who are not
receiving title II or RRB benefits, who reside in an auto-accrete State, and are not
enrolled for SMI. OS will prepare an attainment claims package for release to the
servicing DO/BO requesting Medicare development (See HI 00810.010). Instructions for processing the attainments and leads claims package are contained
in HI 00810.010.
When the State buy-in is based on SSI payments in an auto-accrete State, the DO /BO
need not contact the State public assistance agency to verify Medicaid eligibility.
Instead, the DO/BO will prepare an RC stating “Medicaid eligibility based on receipt of SSI payments,” and include the RC with the completed title XVIII application when it is forwarded
to the PSC.