Section 1837 (k) of the Social Security Act provides a 6- month special enrollment period (SEP) for Medicare Part B and Premium Part A for an individual who:

• •

  either (a) elected not to enroll (or to be deemed enrolled, see HI 00805.040) when first eligible for an initial enrollment period (IEP), or (b) terminates enrollment while serving as a volunteer; and

• •

  is serving as a volunteer outside of the United States through a program that covers at least a 12-month period; and (b) is sponsored by a tax-exempt organization describe in section 501 (c)(3) of Internal Revenue Code of 1986 and is exempt from taxation under section 501 (a) of the Internal Revenue Code of 1986; and (For the definition of sponsoring, see Section B below)

• •

  the individual demonstrates that he or she has (or had) health insurance that provided coverage to the individual while he or she was outside of the U.S. for the duration of the volunteer service. Evidence of coverage under a national health plan is acceptable health coverage for this SEP. See HI 00805.295

NOTE: The beneficiary is serving as a volunteer through a program that covers at least a 12- month period; however, the beneficiary does not need to serve as a volunteer for 12 months in order to qualify for his SEP.

EXCEPTION: Individuals who are entitled to Premium- Part A under the Premium-Part A for the Working Disabled provision are not eligible to enroll during the SEP for International Volunteers.

A sponsoring organization may be a social, religious, educational, scientific, or charitable organization The program sponsoring organization must be described in section 501(a) (c)(3) of the Internal Revenue Code (IRC) of 1986 and exempt from taxation under section 501(c)(3) of the IRC of 1986.

The following are key limitations on these organizations:

• •

  no part of the net earnings of the sponsoring organization may inure^[1] to the benefit of any private share holder or individual

• •

  no substantial^[2] part of the activities of the sponsoring organization may be carrying on propaganda^[3] , otherwise attempting, to influence legislation (except as otherwise provided or permitted in section 501(h) of the IRC); and

• •

  the sponsoring organization must not participate in, or intervene in (including the publishing or distributing of statements), any political campaign on behalf of ( or in opposition to) any candidate for public office. See HI 00805.355

The sponsoring organization can be a corporation(s) or any community chest, fund, or organized foundation that operates exclusively for:

• •

  religious purposes,

• •

  charitable purposes,

• •

  scientific purposes,

• •

  testing for public safety purposes,

• •

  literary or educational purposes,

• •

  fostering national or international amateur sports competition (but only if no part of its activities involve the provision of athletic facilities or equipment), or

• •

  the prevention of cruelty to children or animals.

An individual is eligible to enroll during the SEP if he or she meets the requirements discussed in HI 00805.350A, in this section, and one of the following requirements.

The SEP for international volunteers was effective January 1, 2007. Premium-surcharge rollback only applies to months of international volunteer service as defined in HI 00805.350A (in this section) beginning January 1, 2007.

Effective July 1, 2006, or later, an individual who meets the requirements in HI 00805.350A and HI 00805.350C (in this section) is eligible to enroll in Medicare Part B and Premium-Part A during the SEP.

The SEP is the 6-month period beginning on the first day of the month that includes the date that the individual no longer satisfies the eligibility requirements for the SEP. Therefore, SEP begins on the first day of the month that includes the date the individual is:

• •

  no longer serving as a volunteer outside of the United States;

• •

  no longer has health insurance coverage while serving as a volunteer,

• •

  no longer serving in a program that covers at least a 12-month period and is sponsored by a non-profit organization (loss of tax-exempt status). Either a change in the duration of the volunteer program or in the tax-exempt status of the organization sponsoring of the program will trigger the SEP.

Examples:

• •

  An individual stops being a volunteer on October 25, 2019. The SEP begins on October 1, 2019, and lasts a total of 6 months. Thus, the individual’s SEP would be from October 2019 – March 2020.

• •

  An individual is volunteering abroad and the non-profit stops providing health coverage on December 15, 2019. The SEP would begin December 1, 2019, and end May 31, 2020.

• •

  An individual is volunteering abroad and the non-profit organization sponsoring the volunteer program loses its tax exempt status (it is no longer a non-profit organization) on April 10, 2020. The SEP would begin April 1, 2020 and end September 30, 2020.

Coverage is effective the first day of the month following the month of Medicare

Part B or Premium-Part A enrollment.

See HI 00805.277 for processing instructions below.

• •

  HI 00801.170 Premium-HI for the Working Disabled

• •

  HI 00805.015 Initial Enrollment Period

• •

  HI 00805.040 Automatic (Deemed) Enrollment Aged and Disabled Individual

• •

  HI 00805.295 Evidence of GHP or LGHP coverage based on Current Employment Status

• •

  HI 00805.355 Evidentiary Requirements for the SEP or Premium Surcharge Rollback for International Volunteers

• •

  HI 01001.010 Premium Increase for Late Enrollment

• •

  SM 00850.550 Special Enrollment for International Volunteers for detailed MACADE coding instructions

Footnotes

1. 1. 

   Insure means to be applied; to serve to the use

2. 2. 

   Substantial means of considerable importance, size, number or amount

3. 3. 

   Propaganda means information, especially of a biased or misleading nature, used to promote or publicize a particular political cause or point of view

• •