TN 19 (03-93)

HI 00805.140 Enrollment Action - Claim for Entitlement Pending When IEP or GEP Begins

A. Introduction

Although most individuals who file applications which establish HI entitlement will be automatically enrolled for SMI, there will continue to be cases in which the individual is not subject to deemed enrollment (e.g., those whose applications are denied and do not establish HI entitlement).

B. Policy

In any case where:

  • an individual expresses a desire for SMI during or shortly before an enrollment period, and

  • there is any doubt about his/her HI entitlement,

the individual should be advised to file, as soon as possible, a signed statement that he/she wants SMI, preferably on a Form HCFA-4040 (Application for Enrollment in Supplementary Medical Insurance Benefits Plan).

Similarly, when a claim for HI (which may be part of a monthly benefit claim) is being disallowed and the individual is currently within an enrollment period, but has not specifically elected SMI, an election should be obtained before the enrollment period expires.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600805140
HI 00805.140 - Enrollment Action - Claim for Entitlement Pending When IEP or GEP Begins - 04/23/2015
Batch run: 04/23/2015
Rev:04/23/2015