---
kind: "section"
citation: "42 C.F.R. § 407.43"
title: "42"
number: "407.43"
heading: "Buy-in groups available to Puerto Rico, Guam, the Virgin Islands, and American Samoa."
url: "https://uscodex.org/cfr/42/407.43"
---

# §407.43. Buy-in groups available to Puerto Rico, Guam, the Virgin Islands, and American Samoa.

- (a) **Categories included in buy-in groups.** The buy-in groups that are available to Puerto Rico, Guam, the Virgin Islands, and American Samoa, which are not covered by the SSI program, are described in [paragraph (b)](#b) of this section in terms of the following categories:
  - (1) **Category A—** Individuals receiving OAA, AB, APTD, or AFDC.
  - (2) **Category B—** Individuals who, under the Act or any other provision of Federal law, are treated, for Medicaid eligibility purposes, as though they were receiving AFDC.
  - (3) **Category C—** Individuals who, in accordance with [§ 436.112](/cfr/42/436.112.md) of this chapter, are covered under the State's Medicaid plan despite the increase in social security benefits provided by Public Law 92-336.
  - (4) **Category D—** Individuals who are Qualified Medicare Beneficiaries. 1
  - (5) **Category E—** All other individuals who are eligible for Medicaid.
- (b) **Buy-in groups available.** Puerto Rico, Guam, the Virgin Islands, and American Samoa may choose any of the following coverage groups:
  - (1) **Group 1—** Categories A through E.
  - (2) **Group 2—** Categories A through D.
  - (3) **Group 3—** Categories A through C.
  - (4) **Group 4—** Individuals in category D, and individuals in categories A and B who are not social security or railroad retirement beneficiaries.
  - (5) **Group 5—** Individuals in categories A and B who are not social security or railroad retirement beneficiaries.
  - (6) **Group 6—** Individuals in category D, individuals in category A who are receiving OAA, and individuals in category C who are included in that category (in accordance with [§ 436.112](/cfr/42/436.112.md) of this chapter) because they received OAA for August 1972 or would have been eligible to receive OAA for that month if they had applied or had not been institutionalized.
  - (7) **Group 7—** Individuals in category A who are receiving OAA, and individuals in category C who are included in that category (in accordance with [§ 436.112](/cfr/42/436.112.md) of this chapter) because they received OAA for August 1972 or would have been eligible to receive OAA for that month if they had applied or had not been institutionalized.
  - (8) **Group 8—** Individuals in category D and individuals in category A who are receiving OAA and are not social security or railroad retirement beneficiaries.
  - (9) **Group 9—** Individuals in category A who are receiving OAA and are not social security or railroad retirement beneficiaries.

## Notes

### Amendments

[56 FR 38082, Aug. 12, 1991]

### Authority

Authority: 42 U.S.C. 1302, 1395p, 1395q, and 1395hh.

### Source

Source: 53 FR 47204, Nov. 22, 1988, unless otherwise noted.

### Amendments

[56 FR 38082, Aug. 12, 1991]