US · guidance
CMS Pub. 100-01, ch. 2, § 40.4
Nature and Purpose of State Buy-in
Under the State Buy-in program, states, the District of Columbia, and the U.S. territories
may enter into buy-in agreements with CMS to enroll certain individuals who are dually
eligible for Medicare and Medicaid into Medicare Part B and pay the premiums on their
behalf.
Most states have expanded their buy-in agreements to also include payments of Part A
premiums for individuals who must pay a premium to enroll in Medicare Part A and who
are eligible for the Qualified Medicare Beneficiary (QMB) eligibility group. State buy-in
agreements maximize the number of full-benefit Medicaid recipients enrolled in
Medicare, which ensures that Medicare pays primary to Medicaid. State buy-in
agreements also facilitate enrollment in Medicare for low income individuals who are not
eligible for full-benefit Medicaid coverage by paying Medicare premiums and cost
sharing. Please see the Manual for State Payment of Medicare Premiums, chapter 1,
section 1.2 for additional state buy-i n information.
History
(Rev. 11764; Issued 12-22-22; Implementation: 01-01-2023; Effective 01-03-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
3f396421cba7011c82d2770e6eef3e4ac229023822d0e30700efead1904c3355
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