HI 00803.010 EHH Beneficiary Entitled to HI Based on Age, Disability, or End Stage Renal Disease (ESRD)
A. EHH HI concurrent with HI entitlement based on age, disability, or ESRD
Entitlement to Hospital Insurance (HI) under Environmental Health Hazards (EHH) Medicare can exist concurrently with HI entitlement based on age, disability, or ESRD. It is advantageous for a beneficiary entitled to HI based on age, disability, or ESRD to file an application for EHH Medicare if any one of the following applies:
The beneficiary is not currently enrolled in Supplementary Medical Insurance (SMI);
The beneficiary is paying a SMI premium surcharge because of late enrollment;
The date of entitlement to EHH Medicare would be earlier than the date of entitlement to Medicare based on other criteria; or
The beneficiary, who is enrolled in Premium HI, Premium HI and SMI, or SMI only, can now receive free HI.
NOTE: A beneficiary who already has Medicare based on age, disability, or ESRD may choose to apply for EHH Medicare to have his or her record reflect entitlement to Medicare based on EHH.
B. EHH Medicare beneficiary attains age 65 and is eligible to apply for Medicare based on age
An EHH Medicare beneficiary does not need to file a new application for HI at age 65 if he or she is not paying a premium surcharge. However, an EHH Medicare beneficiary may wish to apply for Medicare at age 65 to establish date of birth or quarters of coverage for entitlement to HI based on age. If this occurs, consider entitlement under Title II.