N.Y. Comp. Codes R. & Regs. Tit. 18 §§ 360-7.8

Current through Register Vol. 46, No. 45, November 2, 2024

Section 360-7.8 - Payments of premiums under title XVIII of the Social Security Act (Medicare)

(a) Payment of Medicare part A monthly premiums will be made by the MA program for qualified Medicare beneficiaries and qualified disabled and working individuals, as defined in section 360-7.7 of this Subpart. Payment of Medicare part A monthly premiums for a qualified Medicare beneficiary will begin with the month following the month he or she applies for MA payment of these amounts.

(b) Payment of Medicare part B premiums will be made by the MA program if a recipient is:

(1) enrolled in a voluntary insurance program under Medicare part B;

(2) receiving cash grants as an eligible recipient of public assistance;

(3) receiving chronic care in a medical institution;

(4) receiving care in a public home;

(5) a qualified Medicare beneficiary, as defined in section 360-7.7(g) of this Subpart. The MA program will pay the Medicare part B monthly premiums for a qualified Medicare beneficiary beginning with the month following the month he or she applies for MA payment of these amounts; or

(6) a specified low-income Medicare beneficiary as defined in section 360- 7.7(i) of this Subpart. The MA program will pay the Medicare part B monthly premiums for a specified low-income Medicare beneficiary.

(c) Method of payment.

(1) The State will pay Medicare part B premiums initially for recipients of cash grants. The social services district will be charged periodically for its proportionate share of the premiums. The charge to a social services district cannot exceed 50 percent of the cost of such premium after crediting any available Federal reimbursement.

(2) The social services district will pay the premiums for recipients in chronic care in a medical institution or care in a public home. Each social services district must claim State reimbursement for the cost of the premiums that it paid initially.

N.Y. Comp. Codes R. & Regs. Tit. 18 §§ 360-7.8