8010 - Buy-In Alert - State Initiated Deletion - Alert

This alert is generated to advise the EW that the state has initiated a Medicare Part A and/or Part B deletion because the recipient:

Is deceased per MEDS,
Is no longer Medicare eligible per SSA record,
Has lost Medi-Cal eligibility per MEDS, or
Has a Medi-Cal SOC over $500.

Note: The loss of Medi-Cal eligibility is sometimes the result of a Hold that was not released prior to MEDS Renewal or a discontinuance action that was not rescinded until after the 1st of the following month.

Action Required

If the recipient is deceased, discontinue Medi-Cal benefits effective the last day of the death month.
If the recipient is no longer Medicare eligible, the EW must update the Medicare Detail page to ensure that the Part A and/or B:
Payment Method is deleted (e.g., from “State” to a blank field),
Payment Amount is changed to zero, if necessary, and
New Reported Date is entered (use the date the EW takes action.)

Note: Close the Collect Medicare Expense Detail window if the recipient is no longer entitled to Part A and Part B.

Advise the recipient of SSA’s action and refer the recipient to the local SSA office if appropriate.
If the recipient has lost Medi-Cal eligibility per MEDS, the EW must review the case and take the following action:
- Restore Medi-Cal if the recipient continues to be eligible. CDHS will automatically initiate another accretion transaction to SSA.
- No further action is required if the recipient is no longer eligible.
If the recipient’s SOC is over $500 and chooses to maintain Part B enrollment, allow the Part B premium deduction in the Medi-Cal budget/SOC calculation.

8010 - Buy-In Alert - State Initiated Deletion - Alert

Action Required

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