TN 17 (10-22)

HI 00820.027 Termination of Premium-HI for the Working Disabled

A. POLICY - GENERAL

Premium-HI for the Working Disabled continues until the earliest of the:

  • End of the month following the month the individual is notified that the individual no longer has a disabling impairment.

  • End of the month following the month the individual files a request for termination of Premium-HI.

  • End of the month before the month the individual becomes re-entitled to premium-free HI. In this case:

    SMI coverage continues without interruption.

    The amount of the SMI premium reverts to the standard amount, effective with the first month of re-entitlement to premium-free HI, if the individual was paying a rate increased for late enrollment.

    IMPORTANT: Re-entitlement to disability benefits by an individual required to serve a new 24-month D-HI qualifying period does not result in termination of Premium-HI for the Working Disabled. Premium-HI entitlement continues (and a valid GEP or SEP enrollment may be filed) until the individual becomes re- entitled to premium-free HI based on meeting the 24-month qualifying period requirement.

  • End of the grace period for non-payment of premiums. (See

    HI 01001.095 for a discussion of grace period rules.)

  • Date of death.

B. POLICY — VOLUNTARY TERMINATION

Generally, the same considerations and limitations applicable to processing requests for termination of SMI coverage also apply to processing requests for termination of Premium-HI for the Working Disabled. (See HI 00820.045-HI 00820.070.)

C. PROCEDURE

If an individual indicates that the individual no longer wants Premium-HI for the Working Disabled because of inability to pay the Part A premium, explain the requirement that States pay Part A premiums for “qualified disabled and working individuals (QDWI).” Refer interested individuals to the appropriate State or local Medicaid agency for further information and enrollment.

NOTE: QDWIs are individuals entitled to Premium-HI for the Working Disabled whose income does not exceed 200 percent of the Federal poverty guidelines and whose resources do not exceed twice the SSI resource level.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600820027
HI 00820.027 - Termination of Premium-HI for the Working Disabled - 10/26/2022
Batch run: 10/26/2022
Rev:10/26/2022