The CAO enrolls individuals in Buy-In through an exchange between CIS and IEVS (see Using IEVS, Chapter 10, Exchange #7, Buy-In) or by completing a manual accrete action in the Buy-In system.
NOTE: Using IEVS is available on the Office of Income Maintenance Intranet for internal users.
The CAO will authorize Buy-In as follows:
Complete the Medicare Buy-In section of the Authorization and Instruction Sheet (PW 764) for manual accrete actions, for past periods of eligibility, and for correcting past periods of eligibility.
Example: The eligibility start date for a Healthy Horizons record was February 6. CIS data entry was completed in April. The auto accrete process enrolls the individual in Buy-In as of April. The CAO completes a manual accrete action for the months of Buy-In eligibility before April.
NOTE: If the Medicare benefits are through the Railroad Retirement Board, the CAO must complete a manual accrete action to send a Buy-In enrollment request to CMS.
Authorize in CIS for auto accrete transactions. The Buy-In system will automatically accrete the following category codes and program status codes approved in CIS:
PG/00
A, J, M (all program status codes)
Program Status Codes 65, 66, 67, and 80
Check the Buy-In system in the middle of the next month to make sure that the individual was enrolled in Buy-In.
NOTE: See Using IEVS, Chapter 10, Exchange #7, Glossary, for a description of codes. (Using IEVS is available on the Office of Income Maintenance Intranet for internal users.) If the manual or auto accrete action was not accepted, enter a new manual accrete action in the Buy-In system. Contact the CIS Hotline if you need help.
Send a notice to the applicant.
NOTE: An automated notice is created by CIS telling the applicant that DPW made an enrollment request for Buy-In of Medicare premiums. The notice reason code is 408, option 1. (See Chapter 377, Notices.)
Create alerts for enrollment in Buy-In at a later date. This includes SSI cases closed because of an RSDI cost-of-living adjustment (COLA) if the conditions for age (65) or disability (24 months) were not met at the time of the SSI closing.
Review eligibility for Buy-In when changes take place that require an eligibility review. These changes include, but are not limited to, the following:
A change in income
New personal property or an increase in value of personal property
A change in living arrangements
Tell individuals to contact the Social Security Administration for a Medicare decision at age 64 years and 7 months.
Check IEVS Exchange #6 for notice of stopped SSI benefits. Review eligibility for all other MA categories, such as NMP Special Circumstances, NMP, Healthy Horizons, MNO, or Spend-down. Determine whether the individual can keep getting Buy-In coverage.
Respond to inter-county transfers.
See Using IEVS, Chapter 10, Exchange #7, Buy-In, to decide on Buy-In status. (Using IEVS is available on the Office of Income Maintenance Intranet for internal users.)
OPS101101 Changes to Buy-In Enrollment Due to Garcia v Johnson (Linked March 25, 2011)
Updated February 14, 2012, Replacing March 24, 2011