Medicare Buy-In Program Helps with Part A Premium Costs
Early last year, we reported that Medicaid can pay the Medicare Part A premium for certain individuals who do not qualify for free Part A through the Medicare Savings Program, also known as the “buy-in” program. PHLP and our partners at PA MEDI continue to hear from individuals with limited incomes and resources who are eligible for Medicaid to pay their Medicare Part A premiums but are not receiving this benefit. Most of the individuals who have reached out to PHLP and PA MEDI regarding this issue are recipients of Supplemental Security Income (SSI). Often, when a person receiving SSI reaches the age of 65 and enrolls in Medicare Part B, Pennsylvania Medicaid covers the Medicare Part B premium through the Part B buy-in program, but they are not enrolled in the Part A buy-in. Although people who are receiving SSI at age 65 are entitled to Medicare Part A, they often do not qualify for premium-free Part A due to insufficient qualifying work history. Consequently, they are not enrolled in Part A until Pennsylvania Medicaid takes action to approve them for the Part A buy-in program.
In these situations, the County Assistance Office needs to take action to enter the Part A buy-in request in the system. Caseworkers refer to this action as a “manual accretion”. After the Part A buy-in request is accepted, the person will be enrolled in Medicare Part A and receive a new Medicare card showing both Part A and Part B coverage. Individuals with full Medicaid who only have Medicare Part B have full medical coverage and can utilize their Medicaid coverage for hospital care or other inpatient services typically covered by Medicare Part A.
Readers can find more information, including links to Part A buy-in eligibility rules and policy clarifications, to help people get Part A buy-in or troubleshoot problems here. The 2024 Medicare Savings Program guide can be found in the Resource Library of PHLP’s website here.
More information to assist individuals in obtaining Part A buy-in or troubleshoot problems can be found here. PHLP’s 2024 Medicare Savings Program guide is available through our Resource Library.
