Medicare Entitlement/Buy-In Indicator - April

SAS Name
MDCR_ENTLMT_BUYIN_IND_04

Monthly Part A and/or Part B entitlement indicator (April).

Comments

This variable indicates whether the beneficiary was entitled to Part A, Part B, or both for a given month. There are 12 monthly variables - where the 01 through 12 at the end of the variable name correspond with the month (e.g., 01 is January and 12 is December).The variable also indicates whether the beneficiary’s state of residence paid his/her monthly premium for Part B coverage (and Part A if necessary). State Medicaid programs can pay those premiums for certain dual eligibles; this action is called “buying in” and so this variable is the “buy-in code.”

Source: CMS Common Medicare Environment (CME)

Code Code value
0 Not entitled
1 Part A only
2 Part B only
3 Part A and Part B
A Part A state buy-in
B Part B state buy-in
C Part A and Part B state buy-in