Aged, Blind, Disabled (ABD): Buy-In – What is Buy-In?

What is Buy-In?

“Buy-in” is the procedure whereby the Oklahoma Health Care Authority (OHCA) pays the client’s Medicare premium through the Centers for Medicare & Medicaid Services (CMS).

  • DHS determines eligibility and oversees operation of Buy-in Program
  • CMS oversees Medicare program
  • Social Security Administration (SSA) enrolls people in Medicare
  • The Buy-in programs are QMB, SLMB and QI-1.

BENDEX will indicate when someone has Medicare Part A or B

  • Block B40—Part A Medicare Start Date
  • Block B45—Part B Medicare Start Date
  • “Part A Buy-in” is the procedure whereby the OHCA pays the Medicare Part A premium for individuals determined eligible as Qualified Medicare Beneficiaries Plus (QMBP) who are enrolled in Part A and are not eligible for premium free enrollment as explained under Medicare Part A. This also includes individuals determined to be eligible as Qualified Disabled and Working individuals (QDWI).
  • “Part B Buy-in” is the procedure whereby the OHCA pays the Medicare Part B premium for individuals who are eligible for Part B Medicare. This includes individuals who receive Aged, Blind or Disabled Services or are approved for End Stage Renal Disease Medicare, and are eligible for Qualified Medicare Beneficiary Plus (QMBP) / Specified Low Income Medicare Beneficiaries (SLMB) or Qualifying Individual -1 (QI-1). Also included are individuals who continue to be categorically needy under the PICKLE amendment and those who retain eligibility after becoming employed. Qualified Disabled and Working Individuals (QDWI) are not eligible for Part B Buy-In.
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