Md. Code Regs. 10.09.24.03-4

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.24.03-4 - Medicare Buy-In Coverage for Medical Assistance Recipients

A. If a recipient, who is determined federally eligible and enrolled in Medical Assistance or the Maryland Children's Health Program according to the requirements of this chapter or COMAR 10.09.11, is entitled to hospital insurance benefits under Medicare Part A, or medical insurance benefits under Medicare Part B, or both, with or without payment of premiums, the Medical Assistance program shall provide the same coverage of Medicare savings program expenses as specified for a Qualified Medicare Beneficiary under Regulation .03-3E of this chapter.

B. A qualified recipient is automatically made eligible by the Department for the Medicare buy-in benefits effective the first day of the:

(1) Second month after the month in which the individual is determined eligible for Medical Assistance or the first day of the third month of Medicare entitlement, whichever date is later, if the individual is eligible in a long-term care or spend down coverage group; or

(2) Month that the individual is eligible for both Medical Assistance and Medicare, if the individual is eligible under COMAR 10.09.24 or COMAR 10.09.11 for Medical Assistance in any coverage groups other than long-term care or spend down.

C. A recipient's eligibility for Medicare buy-in benefits shall continue until the recipient is determined ineligible.

Md. Code Regs. 10.09.24.03-4

Regulation .03-4 adopted effective June 7, 2004 (31:11 Md. R. 856)
Regulation .03-4A amended effective December 27, 2010 (37:26 Md. R. 1787)