Effective Dates: 09/17/2025 - Present Previous | Next

TN 88 (09-25)

HI 00801.027 Taking the Claim

A. Procedure - initial interview

When an individual age 64 years and 9 months or older contacts the Social Security Administration (SSA) to file for Medicare, ascertain whether the individual wishes to file for both monthly benefits and hospital insurance (HI), or for HI only. If, after you make the appropriate explanations, you determine that it is advantageous not to establish Retirement Survivors Insurance (RSI) benefit entitlement, advise the claimant to file for HI only.

If there is any doubt about whether it is advantageous to file for monthly benefits, advise the claimant to file since the monthly benefit portion of the application can always be withdrawn later should such action prove to be advantageous.

B. Procedure - Hospital Insurance only claim

1. General

If a person wishes to file for HI only and a paper application is needed, have the person (or the person's representative) file using the CMS-18-F-5, Application For Part A (Hospital Insurance)

2. Filing by number holder

Obtain proof of age and verify that the individual is insured for Retirement Insurance Benefits (RIB).

3. Filing by auxiliary

If the number holder (NH) is not filing for monthly benefits for self , obtain proof-of-age and evidence of insured status for the NH. Also, if the NH is under age 62 and eligible for, but not entitled to Disability Insurance Benefits (DIB), obtain evidence of disability.

For the applicant, obtain proof-of-age and insured status and, as appropriate, evidence of relationship, dependency, support, and disability (in the unusual case where claimant is 65 or over and eligible for Childhood Disability Beneficiary (CDB)).

NOTE: To determine marital relationships, follow GN 00305.005

4. Filing by survivor

For the NH, obtain proof of death and evidence of insured status.

For the applicant, obtain proof-of-age and insured status and, as appropriate, evidence of relationship, dependency, support, and disability.

NOTE: To determine marital relationships, follow GN 00305.005.

C. References

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600801027
HI 00801.027 - Taking the Claim - 09/17/2025
Batch run: 09/17/2025
Rev:09/17/2025