TN 28 (07-95)

A. Introduction

Many ESRD patients are eligible for State buy-in because they are eligible for Medicaid as well as for Medicare.

B. Policy

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.

C. Reference

State buy-in procedures, HI 00815.001ff.