Effective 7/73, HI is available on a voluntary basis for uninsured persons excluded
under the deemed insured provision because they do not have sufficient QC's, or because
they are, or could have been, covered under the FEHBA program.
For convenience, the term “Premium-HI” is used to help distinguish rules applicable to this group of eligible individuals.
The persons who has Premium-HI is an “HI enrollee” rather than a beneficiary.
Eligible persons must enroll timely for Premium-HI, pay a monthly premium (see HI 01005.011) and enroll or already be enrolled for SMI. They must also meet the same age and
citizenship/residency requirements as those qualifying under the “deemed insured” provision.
Persons are able to enroll even though they are excluded under the deemed insured
provision because they or their spouses at one time had an option to be covered under
the Federal Employees Health Benefits Act of 1959. The exclusion of persons convicted
of certain crimes against the U.S. (HI 00801.086) does not directly apply to Premium-HI. However, conviction for such crimes does
preclude enrollment for SMI, which is necessary for enrollment in Premium-HI.