[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: 42CFR407.48]



[Page 271-272]

 

                         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. 407.48  Termination of coverage under a State buy-in agreement.



    An individual's coverage under a buy-in agreement terminates with 

the earliest of the following events:

    (a) Death. Coverage ends on the last day of the month in which the 

individual dies.

    (b) Loss of entitlement to hospital insurance benefits before age 

65. If an individual loses entitlement to hospital insurance benefits 

before attaining age 65, coverage ends on the last day of the last month 

for which he or she is entitled to hospital insurance.

    (c) Loss of eligibility for the buy-in group. If an individual loses 

eligibility for inclusion in the buy-in group, buy-in coverage ends as 

follows:

    (1) On the last day of the last month for which he or she is 

eligible for inclusion in the group, if CMS determines ineligibility or 

receives a State ineligibility notice by the 25th day of the second 

month after the month in which the individual becomes ineligible for 

inclusion in the group.

    (2) On the last day of the second month before the month in which 

CMS receives a State ineligibility notice later than the time specified 

in paragraph (c)(1) of this section. A notice received by CMS after the 

25th day of the month is considered to have been received in the 

following month.

    (d) Termination or modification of buy-in agreement. If the State's 

buy-in agreement is terminated, or modified to substitute a narrower 

buy-in group,



[[Page 272]]



coverage ends on the last day of the last month for which the agreement 

was in effect, or covered the broader buy-in group.



[53 FR 47204, Nov. 22, 1988, as amended at 56 FR 38082, Aug. 12, 1991]