Follow the procedures below in handling timely protests of enrollment.
If a timely protest as shown in B. is received:
-
•
delete the erroneous period of SMI coverage, and
-
•
refund any premiums paid provided that the individual repays any SMI benefits paid pursuant to the erroneous enrollment.
-
•
Record on a Form SSA-795 the individual's statement that they did not want SMI, and
the agreement to repay any SMI benefits paid by the Medicare program.
EXAMPLE: Mr. Thomas (Number Holder (NH)), age 71, files a GEP election of SMI during 3/ 90.
Mr. Thomas application is erroneously handled like a special enrollment period and
NH is awarded SMI coverage effective 4/90. Shortly after receiving the award notice,
NH protests the SMI award because NH will continue to be covered under NH employer
group health plan until NH retires on 6/30/90.
The SMI award is corrected to 7/90. The erroneous period of SMI coverage is deleted
and SMI premiums withheld from NH social security checks are refunded to NH.
On the other hand, if Mr. Thomas does not protest until more than 6 months after the
month the SMI entitlement notice was sent to the address on record. Mr. Thomas protest
can only be treated as a request for voluntary termination, see HI 00820.035 B.4.