An individual has a new IEP when he/she:
develops ESRD after he/she is entitled to HI based on age or disability, and
The individual is automatically enrolled in R-SMI, along with R-HI, unless he/she
refuses R-SMI. The new IEP begins 3 months before and ends 3 months after the first
month of R-HI entitlement.
If the individual is already enrolled in SMI based on age or disability, but is paying
a premium surcharge for late enrollment, the premium is reduced to the standard rate
effective with the first month of R-HI entitlement.
EXAMPLE: Mr. Martinez has been a DIB beneficiary since 2/96. He refused SMI when he became
entitled to D-HI in 2/98. He filed for SMI in the 2000 GEP and was assessed a 10 percent
premium surcharge for late enrollment upon becoming entitled as of 7/1/00.
In 11/02, Mr. Martinez began a course of renal dialysis and filed for R-HI. His R-HI
is effective with 2/1/03 and his SMI premium is reduced to the standard amount effective
If Mr. Martinez had not enrolled in SMI during the 2000 GEP, he could also have enrolled
in R-SMI effective with 2/1/03 with no premium surcharge.