Effective Dates: 05/01/2025 - Present Previous | Next

TN 124 (05-25)

HI 00805.245 Development for SMI Enrollment of Civil Service Annuitants and Their Spouses

A. Policy - Interviewing

1. Annuitants

During the course of obtaining an application for Supplementary Medical Insurance (SMI) from an individual who is:

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    not entitled to monthly benefits under Social Security (SS),

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    not entitled to an annuity or pension under Railroad (RR), and

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    not eligible for coverage under a State buy-in agreement,

the district office (DO) should ask whether or not the applicant is a Civil Service annuitant or the current spouse of an annuitant.

If a person enrolling is an annuitant, this information and the civil service annuity number should be shown in the file. The claim should not be sent to the Program Service Center (PSC) until the correct annuity number is obtained. Otherwise, rejection, incorrect premium collection or delay in collection for several months will occur.

2. Spouse of annuitant

Where an annuitant's current spouse is enrolled in SMI and subject to SMI premium direct payments, the annuitant's spouse may also have SMI premiums withheld from the annuitant's monthly check if the annuitant consents in writing or verbally and the spouse is:

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    enrolled in SMI;

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    not entitled to a civil service annuity or any Social Security Retirement, Survivors, or Disability Insurance (RSDI) or RR benefits, and

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    not subject to State buy-in.

This arrangement is optional for the convenience of the annuitant and the spouse.

NOTE: Office of Personnel Management (OPM) will only deduct for a current spouse.

The annuitant must consent in writing or verbally to OPM's deduction of the spouse's SMI premiums from the annuitant's monthly check. The written authorization from the annuitant may be similar to the following:

I agree that the monthly premium to cover medical insurance for my spouse (name), be deducted from my civil service annuity check.

3. Civil Service Annuity (CSA) annuity number

The exact annuity number including the designation Civil Service Annuity (CSA) (retired annuitant) or Civil Service Final (CSF) (survivor annuitant) must be provided by the claimant.

Annuity numbers are assigned in numeric sequence as awarded.

NOTE: Both CSA and CSF numbers recently entered the seven-digit category although the majority of valid annuity numbers at the present time consists of six-digits. A few annuitants with five-digit numbers are still living and on the annuity rolls.

Annuity numbers of five or fewer digits should be questioned and validated. Two minor annuity designations, LSF and CZC, exist and may contain three and four-digit numbers, but these cases are rare.

4. RSI beneficiary, benefits suspended

Certification for SMI premium deductions from the civil service annuity applies to OPM annuitants who are Medicare beneficiaries who are entitled to Medicare only. These are:

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    insured and age 65 or older (BIC-T)

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    ESRD (BIC-T)

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    deemed insured for Medicare only (BIC-T)

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    insured based on Medicare Qualified Federal Government Employment (BIC-TA) with an OPM annuity and

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    uninsured age 65 or older (BIC- M).

RSDI beneficiaries are subject to SMI premium withholding from their monthly benefit. During periods of suspense, for work or other reasons, the beneficiary makes direct premium payments.

B. Policy - Independent Federal systems

Certification for SMI premium deductions cannot be made from an annuity that is payable by an independent Federal retirement system other than OPM.

C. List of independent Federal systems

The following is a list of independent Federal civilian retirement systems (some of which are quite limited in the scope of their coverage):

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    Federal Employees' Compensation - Federal employees or their survivors may be entitled to employees' compensation which, in some cases, may be received in lieu of a CSC annuity. Employee compensation benefits are administered by the Bureau of Employees' Compensation, Department of Labor.

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    Foreign Service Retirement and Disability System - This system for foreign service employees is administered by the Department of State.

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    Federal Reserve Board Retirement System.

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    Judicial Survivor Annuity System - This system, administered by the Administrative Office of the U.S. Courts, provides survivor's benefits for the widows of Federal judges.

    NOTE: The judges themselves are continued in a salary status when “retired.” Other Federal court employees and their survivors are covered under regular civil service retirement.

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    Lighthouse Service Retirement System - The U.S. Coast Guard administers this system for lighthouse keepers and ancillary personnel.

    NOTE: Upon the annuitant's death, jurisdiction over a survivor claim is transferred to OPM.

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    Tennessee Valley Authority Retirement System.

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    District of Columbia Policemen and Firemen's Retirement System.

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    District of Columbia Public Schoolteachers' Retirement System.

NOTE: Any District of Columbia employee not covered by either of the two special District of Columbia systems is covered by regular Federal civil service retirement.

Except for the benefits and annuities listed above, and for retirement from the Armed Forces, all other Federal retirement systems are administered by OPM. If a claimant says that they are receiving a benefit or annuity from one of the independent systems, this information should be included in the file to explain why the premium deductions will not be made from a CSC annuity

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600805245
HI 00805.245 - Development for SMI Enrollment of Civil Service Annuitants and Their Spouses - 05/01/2025
Batch run: 05/01/2025
Rev:05/01/2025