715.17 When is Part B Buy-In Effective? (MAM)

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Compute the eligibility date for Part B Buy-In according to the most appropriate formula below:

Buy-In due to receipt of financial assistance:

. If an individual is already eligible for Medicare Part B, they are eligible in the first month they become eligible for financial assistance.

. If an individual is already receiving financial assistance and then becomes eligible for Medicare Part B at a later date, begin buy-in the first month they become eligible for Medicare Part B.

. If eligibility for Medicare Part B is discovered late, compute Part B buy-in to restore benefits up to 1 calendar year prior to the date of discovery. For any restoration period in excess of 1 calendar year, contact the Bureau of Data Management (BDM).

Buy-In due to receipt of categorically needy medical assistance:

. Medical assistance applicants already eligible for Medicare Part B are eligible in the first month they become eligible for medical assistance.

. If an individual is already receiving medical assistance and then becomes eligible for Medicare Part B at a later date, begin buy-in the first month they become eligible for Medicare Part B.

. If eligibility for Medicare Part B is discovered late, compute Part B buy-in to restore benefits up to 1 calendar year prior to the date of discovery. For any restoration period in excess of 1 calendar year, contact BDM.

Buy-In due to receipt of QMB:

. Begin buy-in the month after the month in which QMB eligibility is determined.

. If an individual is eligible for QMB and is eligible for buy-in due to receipt of financial or categorically needy medical assistance, the buy-in date is the earliest date they become buy-in eligible.

Buy-In due to receipt of SLMB or SLMB135:

. Begin buy-in the first day of the month of application.

. Retroactive assistance is allowed.

 Exception: Individuals may not be eligible for SLMB135 and Medicaid in the same month.