HI 00801.126 HI for the Uninsured

Effective 7/73, HI is available on a voluntary basis for uninsured persons excluded under the deemed insured provision because they do not have sufficient QC's, or because they are, or could have been, covered under the FEHBA program.

For convenience, the term “Premium-HI” is used to help distinguish rules applicable to this group of eligible individuals. The persons who has Premium-HI is an “HI enrollee” rather than a beneficiary.

Eligible persons must enroll timely for Premium-HI, pay a monthly premium (see HI 01005.011) and enroll or already be enrolled for SMI. They must also meet the same age and citizenship/residency requirements as those qualifying under the “deemed insured” provision.

Persons are able to enroll even though they are excluded under the deemed insured provision because they or their spouses at one time had an option to be covered under the Federal Employees Health Benefits Act of 1959. The exclusion of persons convicted of certain crimes against the U.S. (HI 00801.086) does not directly apply to Premium-HI. However, conviction for such crimes does preclude enrollment for SMI, which is necessary for enrollment in Premium-HI.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600801126
HI 00801.126 - HI for the Uninsured - 11/19/2007
Batch run: 01/27/2009
Rev:11/19/2007