Effective Dates: 10/28/2022 - Present Previous | Next

TN 2 (10-22)

GN 02335.025 Services Paid For—Who May Claim Payment

A. Services Paid by Deceased Beneficiary or Funds of the Deceased Beneficiary's Estate

1. Legal representative

If the services were paid for by the deceased beneficiary or from funds of the deceased beneficiary's estate, payment will be made to the legal representative, if any, of the individual's estate (see GN 02335.040).

2. No legal representative

If the services were paid for by the deceased beneficiary prior to death and no legal representative has been appointed, payment will be made to certain survivors of the beneficiary in the following order of priority:

  1. a. 

    To the surviving spouse who was either living in the same household with the beneficiary at the time of death, or entitled to monthly social security or railroad retirement benefits on the same earnings record as the beneficiary for the month of death (see GN 02335.050 B.);

  2. b. 

    To the child(ren) of the beneficiary who was entitled to monthly social security or railroad retirement benefits on the same earnings record as the beneficiary for the month of death (see GN 02335.050 C.);

  3. c. 

    To the parent(s) of the beneficiary who was entitled to monthly social security or railroad retirement benefits on the same earnings record as the beneficiary for the month of death (see GN 02335.050 D.);

  4. d. 

    To the surviving spouse of the beneficiary who was not living in the same household with the beneficiary at the time of death, and was not entitled to monthly social security or railroad retirement benefits on the same earnings for the month of death;

  5. e. 

    To the child(ren) of the beneficiary who was not entitled to monthly social security or railroad retirement benefits on the same earnings record for the month of death;

  6. f. 

    To the parent(s) of the beneficiary who was not entitled to monthly social security or railroad retirement benefits on the same earnings record for the month of death.

B. Services Paid by Person Other Than Deceased Beneficiary

When services have been paid for by a person other than the deceased beneficiary, payment will be made to the person or persons who paid for the services. (See GN 02335.035.) If the services were paid for by someone other than the beneficiary and that person died before the Medicare payment to the beneficiary was completed, payment will not be made to that person's estate. Nor does the right to payment pass directly to the legal representative of the beneficiary's estate. In such a case, payment will be made to a surviving relative of the beneficiary in accordance with the priorities listed in A.2. above. If none of the relatives listed survive, payment will then be made to the legal representative, if any, of the beneficiary's estate.

C. No Person Meets the Above Requirements

If no person survives who meets the above requirements, payment may not be made. Furthermore, if a person higher on the priority listing is unavailable or the whereabouts are unknown, payment may not be made to a person in a lower priority. Under the same principle, a person may not waive the right to claim the benefit in favor of a person in a lower priority.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202335025
GN 02335.025 - Services Paid For—Who May Claim Payment - 10/28/2022
Batch run: 10/28/2022
Rev:10/28/2022