Medicare Eligibility Determinations for Aged Supplemental Security Income Recipients

Monday, September 28, 2015
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Audit Report
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The Medicare Buy-In program allows States to enroll certain groups of needy people under the Supplemental Medical Insurance Program, also referred to as Medicare Part B, and pay their premiums. Under the Supplemental Security Income (SSI) program, 33 States and the District of Columbia have entered into agreements with the Social Security Administration (SSA) whereby an individual’s entitlement to SSI payments automatically establishes buy-in coverage for the State to pay their Part B premiums. SSA determines Part B eligibility for these recipients.

The Medicare Attainments and Leads Process (MALP) is an automated system that allows SSA to identify and process Medicare-only claims for uninsured SSI recipients as they near age 65.

In this report, we sought to determine whether SSA timely completed Medicare eligibility determinations for uninsured SSI recipients who had attained age 65.