Minnesota Health Care Programs
1.7.1 Medicare Buy-In
The Medicare Buy-In is an automated data exchange process with the Centers for Medicare & Medicaid Services (CMS) and MMIS, that identifies Medicare premiums that will be paid. This data exchange occurs weekly and includes requests to add or remove a person from the state’s Medicare Buy-In enrollment.
Generally, a person must be enrolled in Medicare before payments for premiums can begin through the Medicare Buy-In. County, tribal, or state servicing agencies notify people who are eligible for Medicare and for payment of the Medicare premium by sending them the Medicare Buy-In Referral Letter (DHS-3439). The letter refers them to the Social Security Administration (SSA) to apply for Medicare benefits.
The Medicare Buy-In does not pay for Medicare Part C or Medicare Part D costs.
Buy-In Eligibility and Payments
There are two ways people are added to the Medicare Buy-In:
- Medicare Savings Programs (MSP) eligibility. Generally, a person must be enrolled in both Medicare Part A and Medicare Part B to be eligible for the Medicare Buy-In through MSPs.
In certain circumstances eligibility for an MSP will begin the Medicare Buy-In. The Medicare Buy-In will pay the Medicare Part A premium even if the person did not previously enroll in Part A and did not pay the premium. See EPM 4.2.1.7 Types of Medicare Savings Programs for more information about each MSP and which premium(s) they pay for.
- Categorical eligibility. A person with certain types of categorical eligibility receives payment of the Medicare Part B premium.
Categorical Eligibility
Certain MA enrollees are automatically added to the Medicare Buy-In when MA is approved. Categorically eligible persons receive payment of the Medicare Part B premium. These enrollees are entitled to premium free Medicare Part A and are enrolled in one of the following programs:
- MA and Minnesota Supplemental Aid (MSA)
- MA status for 1619(a) or 1619(b)
- MA and Housing Support (HS)
- Title IV-E Adoption Assistance
- Title IV-E Foster Care
- Title IV-E Kinship Assistance
Medicare Begin Date for People Turning Age 65
The Medicare Buy-In for MA enrollees who qualify for Medicare because they are turning age 65 may begin the first day of the month of the person's 65th birthday, except when a person turns age 65 on the first day of the month.
SSA deems a person who turns age 65 on the first day of the month eligible for Medicare the first day of the preceding month. A person with a birthday on the first day of the month may be eligible for Medicare Buy-In on the first day of the preceding month.
Legal Citations
United States Code, title 42, section 1395v