DI 45010.035 Notices of Termination
For notification to beneficiary of actual termination of Medicare, the notices shown in DI 45001.098 and DI 45001.099 will be assigned by the earnings review examiner using an SSA-865 (or SSA-573 if appropriate) to the benefit authorizer. These notices of ESRD based terminations of Medicare include conversions from R-HI and/or R-SMI based on age 65 or disability. Be especially careful that notice of conversions to disability based HI-SMI will not be premature—i.e., is there an open CDR or has the issue of CDR been recently resolved to impending disability termination which may (or may not) affect D-HI/D-SMI entitlement in the near future? A disability (CDR) examiner must be consulted in such cases before notification is assigned. File the form on the left side of the folder on top of the SSA-892-U3.
In termination involving a beneficiary for which the MBR shows RRB jurisdicition (“P” option codes), send a manual notice (either DI 45001.103 or DI 45001.104). It is important that the beneficiary be advised that the notice of termination refers only to ESRD Medicare and that his/her HI/SMI entitlement will continue based on the Medicare determination made by RRB.