TN 19 (03-93)

HI 00805.255 SMI Enrollment of Holocaust Survivors

A. Background

In 9/80, special date of birth (DB) procedures were instituted for Holocaust survivors, as explained in GN 00302.325 through GN 00302.340.

B. Policy - General

Where a Holocaust survivor states that the age shown in documentary evidence is an incorrect age, adopted to escape extermination, the person's DB is established based on his/her statement. Since in most cases the individual would be older than the age shown on the document, late enrollment and premium penalties could apply if the DB were established based on the statement. Since no disadvantage was intended by the new procedures, these cases should be handled for SMI enrollment and premium computation as described in this section.

C. Policy - Age 65 or over based on documentary evidence

1. Entitled to SMI

A revised DB based on Holocaust procedure that makes the claimant older than established based on documentary evidence will not cause a premium penalty for late enrollment.

If the claimant was paying an increased SMI premium in the month prior to the month the Holocaust DB is established, no additional premium increase will accrue because of the Holocaust DB.

2. Not currently entitled to SMI

If the claimant was not, but could have been, entitled to SMI based on the documentary evidence, the SMI entitlement date and premium rate will be established based on the documentary evidence even though an earlier DB is established under the Holocaust procedure.

D. Policy - Under age 65 based on documentary evidence

If the individual is under age 65 based on the documentary evidence, but age 65 or over under the Holocaust procedure, SMI is awarded beginning with the same month in which the person is entitled to HI.

If, however, at the time of processing, 6 or more months' retroactive SMI premiums would be due from the individual, SMI begins with the month in which final action is taken to process the award. The individual is given the option of having coverage begin retroactive to the month HI begins. The notice sent to such an individual should be modeled after the notice in HI 00805.195. Regardless of when SMI begins, there is no premium increase for late enrollment.

If the individual is not eligible for monthly benefits and HI and is enrolling for SMI only, coverage is awarded with the month the enrollment request is filed.

If 6 or more months' retroactive premiums are due at processing, the individual is awarded current coverage with the option to have earlier coverage by paying the retroactive premiums.

E. Examples

1. Amended award

Mr. Abel, whose documentary evidence showed that he attained age 65 in 12/ 78, was entitled to SMI beginning 7/80, based on GEP enrollment. Because 12 months had elapsed following the end of his IEP through the end of the GEP, his premium rate was increased 10 percent for late enrollment. Under the Holocaust procedure, his DB was revised as of 9/80 to reflect that he had attained age 65 in 12/76. Even though he was older than originally established, he will continue to be subject to only a 10 percent premium increase.

2. Current award

Mr. Blank filed for reduced benefits in 7/90. His documentary evidence shows a DB of 7/15/28. Under the Holocaust procedures, his DB is established as 7 /15/24. Monthly benefits and HI are awarded 1/90. SMI is awarded 7/90 with the option to elect 1/90. There is no premium increase for late enrollment.

3. Uninsured

Ms. Green is uninsured. She enrolled for SMI in 6/92. Although her documentary evidence shows that she was born 3/17/28, her DB is established under the Holocaust procedure as 3/17/25. SMI is awarded with 6 /92 unless, at the time of processing, more than 6 months' premiums are due. In the latter event, she is awarded SMI beginning with the month action is taken to process an award, with the option to have coverage beginning with 6/ 92. Regardless of when coverage begins, there is no premium increase for late enrollment.

To Link to this section - Use this URL: