We must develop an application for ESRD Medicare (CMS-43) for all Disability (D-HI)
beneficiaries. This is required because R-HI may continue after D-HI terminates. If
retroactivity is involved, R-HI may even begin earlier.
Develop an application for ESRD Medicare from a beneficiary already entitled to Medicare
based on age 65 only if:
The beneficiary is not currently enrolled in SMI;
The beneficiary is paying an increased premium due to late enrollment;
Entitlement to R-HI/R-SMI would be earlier than entitlement based on age 65; or
The beneficiary is entitled to premium-HI and/or SMI only.
If the beneficiary is age 65 or over and there is no advantage in filing for R-HI,
destroy the CMS-2728, ESRD Medical Evidence Report Medicare Entitlement and/or Patient