Most individuals age 65 and older receive Medicare Part A at no cost based on their own or their spouse’s employment. They do not have to pay for it if they or their spouse has worked 40 qualifying quarters. If the individual does not have enough work credits to receive Medicare Part A for free, he may buy Part A and/or Part B.
NOTE: Effective January 1, 1994 there is both a standard and a reduced Part A premium rate. If an individual is required to pay the Medicare Part A premium, DPW will pay the Medicare Part A premium through Buy-In only if the individual is a Qualified Medicare Beneficiary (QMB). QMBs include:
Healthy Horizons recipient. If the individual is paying the Part A premium, the CAO will enroll the individual in Buy-In. If the individual is not receiving Medicare and needs to apply for Part A to establish Medicare eligibility, the CAO will refer the individual to SSA.
NOTE: NMP individuals are also eligible for Buy-In of Part A if they meet the Healthy Horizons eligibility criteria.
SSI recipient.
D 50 and D 00 recipients if eligible for Medicare.
Individuals who meet the QMB income and resource limits found in Appendix A.
The following individuals are not eligible for payment of Part A:
Specified Low Income Medicare Beneficiary (SLMB). The Department pays the monthly Medicare Part B premium and the individual may be eligible for MA, including payment of HCBS and LTC facility services.
Qualifying Individuals (QI). QI’s are only eligible for payment of the monthly Medicare Part B premium. QIs are not eligible for MA and do not receive an ACCESS card.
Issued May 1, 2012