HI 00805.000 Supplementary Medical Insurance Entitlement

Subchapter Table of Contents
Section Latest
Transmittal
HI 00805.001Supplementary Medical Insurance (Part B)TN 19 03-93
ELIGIBILITY REQUIREMENTS
HI 00805.005Eligibility for SMITN 19 03-93
HI 00805.006Enrollee Ceases to Meet Eligibility RequirementsTN 19 03-93
HI 00805.007SMI Eligibility for Foreign ResidentsTN 19 03-93
INITIAL AND GENERAL ENROLLMENT PERIODS
HI 00805.010Rules on Enrollment PeriodsTN 19 03-93
HI 00805.015Initial Enrollment PeriodTN 19 03-93
HI 00805.020Determining the IEP for Aged Alien Non-BeneficiariesTN 19 03-93
HI 00805.025General Enrollment Period (GEP)TN 19 03-93
HI 00805.030Relationship Between Initial and General Enrollment PeriodsTN 19 03-93
AUTOMATIC (DEEMED) ENROLLMENT
HI 00805.035Nature and Purpose of Automatic EnrollmentTN 19 03-93
HI 00805.040Automatic (Deemed) Enrollment - Aged and Disabled IndividualsTN 19 03-93
HI 00805.045Deemed Enrollment - R-HI BeneficiariesTN 19 03-93
HI 00805.050When Deemed Enrollment Does Not ApplyTN 19 03-93
HI 00805.055Notice of Right to Refuse Deemed EnrollmentTN 28 11-14
INDIVIDUAL ENROLLMENT
HI 00805.060Voluntary Request for EnrollmentTN 19 03-93
HI 00805.065Enrollment Form Not in FileTN 19 03-93
HI 00805.070Who May Execute a Valid Request for SMI EnrollmentTN 19 03-93
HI 00805.075Prescribed SMI Enrollment FormsTN 26 11-14
HI 00805.080Withdrawal of Enrollment Before It Goes Into EffectTN 19 03-93
ADDITIONAL ENROLLMENT CONSIDERATIONS
HI 00805.085Effect of Reentitlement to HI After TerminationTN 19 03-93
HI 00805.090SMI Enrollment of Reentitled Disability BeneficiariesTN 19 03-93
ENROLLMENT PROCEDURES
HI 00805.095What Constitutes an Effective EnrollmentTN 19 03-93
HI 00805.100Individual Incapacitated During IEP, GEP, or SEPTN 19 03-93
HI 00805.105Enrollee Needs Help in Paying Premiums or Claiming ReimbursementTN 19 03-93
HI 00805.110SMI Enrollment ProcessesTN 26 11-14
HI 00805.115Enrolling Beneficiaries in SMI who Reside in Puerto RicoTN 26 11-14
HI 00805.120Enrolling Beneficiaries in SMI who Reside in a Foreign CountryTN 28 11-14
HI 00805.125Description of CMS Medicare Initial Enrollment Period Package Information Sent to BeneficiariesTN 28 11-14
HI 00805.126Exhibits of Medicare Initial Enrollment Period PackagesTN 29 10-17
HI 00805.130When an Enrollment Received by Mail Is Considered FiledTN 19 03-93
HI 00805.135Extending the Enrollment PeriodTN 19 03-93
HI 00805.140Enrollment Action - Claim for Entitlement Pending When IEP or GEP BeginsTN 19 03-93
DEEMED INITIAL ENROLLMENT PERIOD
HI 00805.150Deemed IEP Based on Alleged Date of Attainment of Age 65TN 19 03-93
HI 00805.151The Date of Birth to Be EstablishedTN 19 03-93
HI 00805.152Examples of Deemed IEPTN 19 03-93
HI 00805.153Prior Month Attainment RuleTN 19 03-93
HI 00805.154Use of the Deemed IEPTN 19 03-93
HI 00805.155Enrollment Request Filed After Age 65 But Before Deemed Date of AttainmentTN 19 03-93
COVERAGE PERIOD
HI 00805.160Coverage Period DefinedTN 19 03-93
HI 00805.165Individual Enrollment - When A Coverage Period BeginsTN 19 03-93
EQUITABLE RELIEF
HI 00805.170Conditions for Providing Equitable ReliefTN 19 03-93
HI 00805.175Evidence of Government Error or DelayTN 19 03-93
HI 00805.180Payment of Premium ArrearageTN 19 03-93
HI 00805.185Processing Equitable Relief CasesTN 19 03-93
HI 00805.190Common Situations Involving Equitable ReliefTN 19 03-93
HI 00805.195Enrollment Not Processed TimelyTN 19 03-93
HI 00805.200SMI Awarded on Later of 2 Timely Enrollment RequestsTN 19 03-93
HI 00805.205Delayed or Incorrect Advice Frustrated Enrollment or Termination RightsTN 19 03-93
HI 00805.210SMI Awarded ErroneouslyTN 19 03-93
HI 00805.215SMI Terminated ErroneouslyTN 19 03-93
HI 00805.220Inadvertent Failure to Bill for or Deduct Premiums - Non-Buy-In CasesTN 19 03-93
HI 00805.230Delayed Deletion from State Buy-In Rolls Prejudices Termination RightsTN 19 03-93
HI 00805.235Special Considerations for Premium-HITN 19 03-93
HI 00805.236Current Equitable Relief Considerations Involving CHAMPUSTN 19 03-93
HI 00805.240Other Situations Where Equitable Relief May ApplyTN 19 03-93
ENROLLMENT PROCEDURES - SPECIFIC CATEGORIES
HI 00805.245Development for SMI Enrollment of Civil Service Annuitants and Their SpousesTN 19 03-93
HI 00805.250SMI Enrollment for Qualified Railroad Retirement BeneficiaryTN 19 03-93
HI 00805.255SMI Enrollment of Holocaust SurvivorsTN 19 03-93
HI 00805.260Medicare Entitlement for Residents of the Northern Mariana IslandsTN 19 03-93
SPECIAL ENROLLMENT PERIOD AND PREMIUM SURCHARGE ROLLBACK
HI 00805.265The Special Enrollment Period -- DefinitionTN 23 04-01
HI 00805.266Description of Terms Used in the Special Enrollment Period and Premium Surcharge Rollback ProvisionsTN 25 04-12
HI 00805.270General Eligibility Requirements for the Special Enrollment PeriodTN 25 04-12
HI 00805.275Special Enrollment Period (SEP) EnrollmentsTN 25 04-12
HI 00805.276SMI Effective Date for SEP EnrollmentsTN 23 04-01
HI 00805.277Processing SEP EnrollmentsTN 27 11-14
HI 00805.278SEP Enrollments for Aged Beneficiaries with Hours’ Bank ArrangementsTN 27 11-14
HI 00805.280Premium Surcharge Rollback for Individuals With GHP/LGHP CoverageTN 23 04-01
HI 00805.281Examples of the Elimination or Rollback of Premium Surcharges for Individuals With GHP/LGHP CoverageTN 23 04-01
HI 00805.285The SEP and Premium Surcharge Rollback for Individuals Eligible for Premium-HITN 23 04-01
HI 00805.290SEP Requirements for Self-employed BeneficiariesTN 27 11-14
HI 00805.295Evidence of GHP or LGHP Coverage Based on Current Employment StatusTN 27 11-14
HI 00805.300Disability SEP for Beneficiaries for Whom Medicare is Now the Primary PayerTN 23 04-01
HI 00805.310Disability SEP EnrollmentsTN 27 11-14
HI 00805.315GEP Enrollment For Disabled Beneficiaries Who Do Not Enroll During The D-SEPTN 23 04-01
HI 00805.320Equitable Relief for Disabled Individuals Covered Under a GHP/LGHPTN 23 04-01
HI 00805.322Equitable Relief for Domestic (Or Life) Partners Covered Under a GHPTN 25 04-12
HI 00805.325GHP Coverage Under TRICARE (Formerly CHAMPUS)TN 23 04-01
HI 00805.330Individuals with GHP Coverage Under COBRATN 23 04-01
HI 00805.340Exhibit of Form CMS (L564 Request for Employment Information)TN 27 11-14
HI 00805.345CMS Regional Office MSP CoordinatorsTN 23 04-01
HI 00805.350Special Enrollment Period for International VolunteersTN 25 04-12
HI 00805.355Evidentiary Requirements for the SEP or Premium-Surcharge Rollback for International VolunteersTN 25 04-12
HI 00805.360Processing SEP Enrollments for International VolunteersTN 24 03-07
HI 00805.365Premium Surcharge Rollback for International VolunteersTN 24 03-07
HI 00805.370Processing Requests for SMI and/or Premium - HI TerminationTN 24 03-07
INFORMATIONAL BACKGROUND
HI 00805.700Outmoded Rules on Enrollment Periods and CoverageTN 19 03-93
HI 00805.705Supreme Court Decision Affecting the Alien Residence Requirement for SMI ( Mathews v. Diaz )TN 19 03-93
HI 00805.710Special One-Time Enrollment for Certain Merchant SeamenTN 19 03-93
HI 00805.720Equitable Relief for Certain Former CHAMPUS BeneficiariesTN 19 03-93
HI 00805.725Equitable Relief for Certain CHAMPVA BeneficiariesTN 19 03-93
HI 00805.730Certain Military Retirees and Dependents Receiving Health Care at Military HospitalsTN 19 03-93
HI 00805.731Change in CHAMPUS Law Required Relief in 1992TN 19 03-93
HI 00805.735Cuban Refugees Whose Status Was Adjusted Under P.L. 89-732TN 19 03-93
HI 00805.740SEP and Premium Surcharge Provisions for the Ages Prior to the 1986 AmendmentsTN 23 04-01
HI 00805.750SEP and Premium Surcharge Requirements in Effect for the Aged Prior to August 1986TN 23 04-01