MCS/EC will automatically recognize “NO WAITING PERIOD” claims when either the primary
or secondary diagnosis code on the Disability Allowance/Denial (DICL) screen equals
NOTE: EC will not reflect a “NO WAITING PERIOD” for Medicare until a Disability Determination Services (DDS) allowance is established and code 3350 is entered on the DICL screen.
Enter “1” (YES) to the question “Will Medicare Apply?” on the Additional Benefits
(ADDB) screen. EC will establish the hospital insurance (HI) START date equal to the
later of the DOED or 07/2001.
Enter the appropriate supplemental medical insurance (SMI) election information on
the Health Insurance (HIHI) screen in the application path.
EC will automatically generate a SMI refusal paragraph (HIB152, see NL 00725.005) advising ALS beneficiaries still in their initial enrollment period (IEP) who refuse
SMI on their application that they still have a chance to elect SMI if they respond
timely. However, if they do not respond timely and wish to enroll, they will have
to wait for a general enrollment period or file under the special enrollment period
provision if applicable.
EC recognizes equitable relief situations and generates paragraph HIB068 (see NL 00725.005) as it would in a regular waiting period case. No additional equitable relief paragraph
input is necessary.