Section 210-RICR-30-05-3.8 - RIte Share Buy-in RequirementA. In certain instances, Medicaid beneficiaries participating in RIte Share are subject to a buy-in requirement. This requirement applies to a household with MAGI-based income above 150% of the FPL where only the child (children) is Medicaid eligible, and the parent/caretaker has access to ESI that is RIte Share-approved. 1. Buy-in amount - The parent/caretaker is required to pay a monthly buy-in amount that varies with income as follows: Monthly Family Income | Monthly Buy-In Amount |
Over 150% and not greater than 185% FPL | $ 61.00 |
Over 185% and not greater than 200% FPL | $ 77.00 |
Over 200% and not greater than 250% FPL | $ 92.00 |
2. Notice - EOHHS must provide the adult in the family subject to the buy-in requirement with timely notice. This may be done separately or in conjunction with the notice of RIte Share participation. The notice must include the amount of the buy-in, the process for making payments, the consequences for non-payment and a statement of the right to appeal and request a hearing.3. Payment - Buy-in amounts are not prorated. Therefore, a full monthly buy-in amount is due if RIte Share enrollment is effective for any portion of a coverage month.4. Method of payment - The parent/caretaker either pays the monthly RIte Share buy-in amount to EOHHS or, if the member has direct deposit, EOHHS deducts the buy-in amount from their ESI reimbursement.5. Non-compliance - If the parent/caretaker fails to pay the buy-in amount as required, children and young adults in the family age nineteen (19) and under who are eligible for Medicaid will be enrolled in a Medicaid managed care plan.210 R.I. Code R. 210-RICR-30-05-3.8
Amended effective 8/6/2019