State Payment of Medicare Premiums

States pay Medicare Part B premiums each month for over 10 million individuals and Part A premium for over 700,000 individuals. This process promotes access to Medicare coverage for low-income older adults and people with disabilities, and it helps states ensure that Medicare pays primary to Medicaid for its dually eligible residents.

Draft to Update Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”)

On December 13, 2019, we released a draft Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”) to states and other stakeholders for review and comment. The draft manual updates information and instructions to states on federal policy, operations, and systems concerning the payment of Medicare Parts A and B premiums (or buy-in) for individuals dually eligible for Medicare and Medicaid. The manual update is part of CMS’ Better Care for Dual Eligible Individuals Strategic Initiative (PDF) aimed at improving quality, reducing costs, and improving customer experiences.

Despite the importance of this process, federal guidance on buy-in is out of date. The draft manual reflects current statute, regulation, operations, and systems changes that have evolved over time. Additionally, the draft manual re-organizes content to make it easier for states to discern federal requirements and find information.

We are welcoming comments through 5:00 p.m. EST on February 29, 2020 to CMS at ModernizetheMSPs@cms.hhs.gov.

The Cover Memo (PDF)

The Draft Manual (PDF)

Comment Submission Instructions

You must use the Excel Comment (XLSX) document:

  • Note the organization name, contact name, contact email and telephone number.
  • Submit comment/question submission in the following format:
    • Use one line per comment/question
    • Note section name and number, page number, and description of issue/question in the designated columns 
    • Describe specific revision/comment in the “comment” column
  • Save the excel document using your organization’s name and the date, e.g. “State_Payment_Medicare_Premium_ORGANIZATION_02.28.2020”

Technical Assistance Webinar: Draft to Update Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”)

This webinar provides a brief overview of major changes to the updated Manual for State Payment of Medicare Premiums (formerly called “State Buy-in Manual”).

State Payment of Medicare Premiums Page: Webinar Screenshot

 

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Page Last Modified:
12/19/2019 12:37 AM