See GN 00204.010 for full instructions on the circumstances under which a statement filed with a hospital
by, or on behalf of, an inpatient will protect the filing date for HI. A statement
meeting the conditions of GN 00204.006 and GN 00204.010A.4. protects the filing date for HI, not only under the regular insured provision,
but under all HI entitlement provisions (i.e., deemed insured, ESRD, Premium-HI, and
even for the disabled who can establish HI as of the first month of entitlement to
a second period of disability benefits because they met the 24-month waiting period
requirement during an earlier period of disability entitlement). To protect entitlement
to Premium-HI, however, the individual must have completed the statement during an
enrollment period and already be entitled to SMI, or have filed a request for SMI
during a prescribed enrollment period.
NOTE: A protective statement for HI may not be construed as an intent to enroll in SMI.
However, as in all insured cases (including deemed insured) where automatic enrollment is applicable, an individual
who is entitled to HI is automatically enrolled in SMI as of the initial enrollment
period (IEP), current general enrollment period (GEP), or following GEP (whichever
is applicable), unless he or she specifically refuses the SMI enrollment. Thus, when
the statement filed with a hospital is used to protect the HI filing date, the individual
(if subject to automatic enrollment) is also enrolled in SMI based on that same statement.