TN 7 (10-15)

DI 28075.025 Processing Medicare for Qualified Government Employment (MQGE) Cases

A. Policy for MQGE cases

1. Eligibility criteria

To be eligible for Medicare coverage based on disability, an individual must meet the definition of disability in the Social Security law.

2. Continuing disability reviews (CDR)

The MQGE individuals are subject to all conditions and reviews that apply to regular Title II disabled individuals (e.g., extended period of eligibility (EPE), medical and trial work period (TWP) diaries).

B. Procedure

1. Cessation cases

Follow these instructions for cessation cases:

  1. a. 

    Prepare a Form SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal – Title II). Enter “MQGE only” in item 24.

  2. b. 

    Prepare a notice to the individual using appropriate paragraphs as instructed in DI 28095.105.

  3. c. 

    In EPE cases prepare a notice to the individual using appropriate paragraphs as instructed in DI 13010.215A.

  4. d. 

    Route folder to FO.

2. Continuance cases

Follow these instructions for continuance cases:

  1. a. 

    Prepare a Form SSA-833 determination and enter “MQGE only” in item 24.

  2. b. 

    Send an SSA-L270-U2 (Social Security Disability Information) to the individual. For an exhibit of SSA-L270-U2, see DI 31515.201.

  3. c. 

    Route folder to FO, as appropriate. If the folder is electronic, insert “Attn: Disability Examiner. See Form SSA-833 in file” on the Alerts and Messages screen. If folder is paper, attach SSA-408 annotated with “Attn: Disability Examiner. See Form SSA-833 in file.”


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428075025
DI 28075.025 - Processing Medicare for Qualified Government Employment (MQGE) Cases - 10/20/2015
Batch run: 10/20/2015
Rev:10/20/2015