TN 29 (07-25)

HI 00820.055 Cancellation of Voluntary Termination Request

Policy

1. When and how an individual can cancel a voluntary termination request

 

An individual may cancel a request for termination by a signed statement filed on or before the last day of SMI coverage, except as described in HI 00820.055.2 and HI 00820.055.3. (The last day of SMI coverage may be a Saturday, Sunday, legal holiday or any other day all or part of which is declared to be a nonwork day for Federal employees by statute or Executive Order. In that case, a request for cancellation of termination received on the next regular workday will be treated as if filed on the last day of SMI coverage.)

The cancellation need simply state, in effect: “I want to keep my Medicare medical insurance. Please disregard my previous request to stop this insurance.” The statement must be signed by the enrollee, and should show both the enrollee's address and Medicare Number. If the enrollee is incapable of transacting business, the request may be signed by a representative payee or, in the case of a nonbeneficiary, by someone providing care or financial support.

If there is a request to rescind a termination based on a claim that the beneficiary was incompetent when making the termination request, see HI 00820.045.

2. Instructions on when cancellation can occur

There will be only 30 to 60 days in which to revoke the termination before it takes effect, except for voluntary terminations when state buy-in ends. If a beneficiary files a voluntary termination after state buy-in ends, and later decides they acted hastily, reinstate Part B if the request to cancel is received on or before the 60th day after the date the voluntary termination is filed. For information about voluntary terminations when state buy-in ends, see Implications and Options for Beneficiaries When State Payment of Medicare Premiums (State Buy-in) Ends, HI 00815.042.B. Clearly inform the individual what action is necessary and when it must occur. For this reason, the date of termination block on the CMS-1763 should be filled in legibly.

3. Termination request cancelled during GEP

If cancellation of a termination request is filed during a GEP after coverage terminated,  the cancellation request is treated as a reenrollment request in the month it is received by the DO or PSC.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600820055
HI 00820.055 - Cancellation of Voluntary Termination Request - 07/16/2025
Batch run: 07/16/2025
Rev:07/16/2025