[Code of Federal Regulations] [Title 42, Volume 2] [Revised as of October 1, 2005] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR407.42] [Page 269-270] TITLE 42--PUBLIC HEALTH CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 407_SUPPLEMENTARY MEDICAL INSURANCE (SMI) ENROLLMENT AND ENTITLEMENT --Table of Contents Subpart C_State Buy-In Agreements Sec. 407.42 Buy-in groups available to the 50 States, the District of Columbia, and the Northern Mariana Islands. (a) Categories included in the buy-in groups. The buy-in groups that are available to the 50 States, the District of Columbia, and the Northern Mariana Islands are specified in paragraph (b) of this section in terms of the following categories: (1) Category A: Individuals who-- (i) Receive SSI or SSP or both; and (ii) Are covered under the State's Medicaid plan as categorically needy. (2) Category B: Individuals who-- (i) Under the Act or any other provision of Federal law are treated, for Medicaid eligibility purposes, as though they were receiving SSI or SSP; and (ii) Are covered under the State's Medicaid plan as categorically needy. (3) Category C: Individuals who are receiving AFDC. (4) Category D: Individuals who, under the Act or any other provision of Federal law, are treated, for Medicaid eligibility purposes, as though they were receiving AFDC. (5) Category E: Individuals who, in accordance with Sec. 435.114 or Sec. 435.134 of this chapter, are covered under the State's Medicaid plan despite the increase in social security benefits provided by Public Law 92-336. (6) Category F: Individuals who are Qualified Medicare Beneficiaries.1 --------------------------------------------------------------------------- \1\ Rules for buy-in for premium hospital insurance for QMBs are set forth in Sec. 406.26 of this chapter. --------------------------------------------------------------------------- (7) Category G: All other individuals who are eligible for Medicaid. (b) Buy-in groups available. Any of the 50 States, the District of Columbia, and the Northern Mariana Islands may buy-in for one of the following groups: (1) Group 1: Categories A through G. (2) Group 2: Categories A through F. (3) Group 3: Categories A through E. (4) Group 4: Categories A, B, and F, individuals in categories C and D who are not social security or railroad retirement beneficiaries, and individuals in category E who are included in that category (in accordance with Sec. 435.134 of this chapter) because they received OAA, AB, APTD, or AABD in August 1972 or would have been eligible to receive such cash assistance for that month if they had applied or had not been institutionalized. (5) Group 5: Categories A and B, individuals in categories C and D who are not social security or railroad retirement beneficiaries, and individuals in category E who are included in that category (in accordance with Sec. 435.134 of this chapter) because they received OAA, AB, APTD, or AABD in August 1972 or would have been eligible to receive such cash assistance for that month if they had applied or had not been institutionalized. (6) Group 6: Categories A, B, and F, and individuals in category E who are included in that category (in accordance with Sec. 435.134 of this chapter) because they received AABD in August 1972 or would have been eligible to receive AABD for that month if they had applied or had not been institutionalized. This option is available only to those States that had an AABD program as of December 31, 1973. [[Page 270]] (7) Group 7: Categories A and B, and individuals in category E who are included in that category (in accordance with Sec. 435.134 of this chapter) because they received AABD in August 1972 or would have been eligible to receive AABD for that month if they had applied or had not been institutionalized. This option is available only to those States that had an AABD program as of December 31, 1973. [56 FR 38081, Aug. 12, 1991]