TN 18 (09-17)

A. State Buy-In Agreements

All State Buy-In Agreements were effective July 1, 1966, except for the following:

Wyoming's previous State Buy-In Agreement was effective from July 1, 1966 through July 31, 1967; and the Commonwealth of the Northern Mariana Islands was effective on July 1, 1989.

A number of states, which have bought in for all of their medical assistance recipients under Title XIX, do not provide Title XIX approved medical assistance to the medically needy. In those states, the only noncash recipients who are eligible for State Buy-in (the Medical Assistance Only (MAO) category) are noncash recipients who are categorically needy; e.g., certain institutionalized individuals.

States with 1634 agreements are known as Supplemental Security Income (SSI) auto accrete states and those states which make all their own Medicaid eligibility determinations are known as 209 (b), or SSI alert, states. States using SSI standards, but making their own State Buy-in determinations, are shown as alert*. All states, except Kentucky (180), include Part A of Title IV, Temporary Assistance to Needy Families (formerly Aid to Families with Dependent Children (AFDC) in their State Buy-in coverage groups. The following chart shows the SSI status of each state:

B. References

• HI 00810.010 How the Medicare Attainments and Leads Process Works

• HI 00815.018 When A Buy-In Coverage Period Begins, Subsection A. CMS Accretion Based on Receipt of SSI or Federally Administered State Supplement

• HI 00815.030 SSA DO/BO Procedures to Develop Buy-In Coverage in Initial Claims Cases — The Public Welfare Accretion Procedure, Subsection A. General, and Subsection C. The PW Process in an Alert State and the PW Process for Non-SSI Recipients in All States

• HI 00815.055 Establishing State Buy-In Eligibility for Railroad Retirement Board (RRB) Annuitants

• HI 00815.082 SSA DO/BO Procedures for Resolving Individual Buy-In Problem Cases Due to Problem with SSR-MBR Interface, Subsection A. Premium Collection for Individual Is Continuing or Claims for Part B Reimbursement Are Denied

• SM 00381.005 Processing Environmental Health Hazard (EHH) Medicare Claims in MCS, Subsection B.4. Health Insurance (HIHI), Health Insurance Third Party (HITP), and Health Insurance for Title XIX and Medicaid (HI19) screens

• SM 00381.006 Processing Simultaneous Claims for EHH Medicare and for Disability Insurance Benefit (DIB) in MCS, Subsection B.2. Health Insurance (HIHI), Health Insurance Third Party (HITP), and Health Insurance-Title XIX and Medicaid (HI19) screens

• SM 00850.190 SMI Third Party Identification Code (CODE)

• SM 03040.040 State Buy-in on Initial Awards, Subsection B. Procedure – entering HI19 data

• SM 10802.040 Reading and Interpreting the MBR Portion of the Full Version Third-Party Query (TPQY) Response, Subsection P.1. Line 19

• TC 24001.030 Supplementary Medical Insurance (SMI) Eligibility and Enrollment, Subsection C. State Buy-in Exception to SMI Enrollment Periods

• TC 24035.080 Resolving State Buy-In Problems, Subsection C. Procedure

Footnotes:

[1]

^. Alabama included MAO 01/01/70 through 09/30/86.

[2]

^. Colorado - alert State 01/74 through 11/81.

[3]

^. Title I - Grants to States for Old-Age Assistance for the Aged.

Title IV - Part A - Aid to Families with Dependent Children.

Title X - Grants to States for Aid to the Blind.

Title XIV - Grants to States for Aid to the Permanently and Totally Disabled.

Title XIX - Grants to States for Medical Assistance Programs.

[4]

^. Indiana Alert State 011/74 through 05/2014

[5]

^. Maryland - alert State 01/74 through 12/74, accrete State 01/75 through 04/79.

[6]

^. Massachusetts DMA included RSDI and RRB beneficiaries receiving SSI or a State supplement under State Buy-in coverage effective 11/01/75. RSDI or RRB beneficiaries receiving cash assistance under Part A of Title IV are not covered under State Buy-in in Massachusetts.

[7]

^. Michigan - accrete State 01/74 through 06/75, alert State 07/75 through 08/76.

[8]

^. Mississippi - alert State 01/74 through 06/81.

[9]

^. New York - alert State 09/80 through 07/82.

[10]

^. North Carolina - alert State 01/74 through 12/94.

[11]

^.Ohio - alert State 04/68 through 08/16.

[12]

^. Vermont - alert State 01/74 through 06/74.

[13]

^. Title I - Grants to States for Old-Age Assistance for the Aged.

Title IV - Part A - Aid to Families with Dependent Children.

Title X - Grants to States for Aid to the Blind.

Title XIV - Grants to States for Aid to the Permanently and Totally Disabled.

Title XIX - Grants to States for Medical Assistance Programs.

[14]

^. Washington - alert State 01/74 through 06/77.

[15]

^. Wisconsin included RSDI and RRB beneficiaries receiving SSI or a State supplement under State Buy-in coverage effective 11/01/75. Beneficiaries receiving cash assistance under Part A of Title IV are covered under State Buy-in effective 04/01/82.