TN 2 (02-91)

HI 00901.225 Health Insurance Card Inquiries - Allegation of Nonreceipt and FO Action

Procedure

1. New Claims Case

When a beneficiary states that a new card has not been received, take the following steps:

StepAction

1

Examine the microfiche or temporary FO records to:

  • verify name, claim number, and entitlement; and

  • determine whether sufficent time has elapsed since the claim was forwarded (see HI 00901.085B).

2If sufficient time elapsed, go to Step 3.
 If not, go to Step 4.

3

Transmit an HMQ (see SM 00706.005). When the replies are received, take one of the following actions:

  • If the MBR and HI records are correct,send a Health Insurance Query (HIC), or,

  • If either the MBR or HI or both are incorrect, follow procedures in HI 00930.001.

4Inform the beneficiary when (s)he can expect to receive the card and advise him/her to recontact the FO if it is not received by then.
5Issue a temporary notice of eligibility if appropriate. See HI 00801.500 - HI 00801.510.

2. Post-Entitlement Action

This table describes the FO action necessary when a beneficiary complains of nonreceipt of a replacement card prompted by a post-entitlement action (e.g., remarriage and SALT input):

StepAction

1

Verify that sufficient time has elapsed for the action to have changed the MBR and HI records. Sufficient time is:

  • 2 weeks if direct input was used and no exception was received.

  • 6 weeks if the change was a paper request to the PC.

2

If sufficient time elapsed, go to Step 3.

If not, go to Step 4.

3

Transmit an HMQ (see SM 00706.005). When the replies are received, take one of the following actions:

  • If the MBR and HI records are correct,send a HIC, or,

  • If either the MBR or HI or both are incorrect, follow procedures in HI 00930.001.

4Inform the beneficiary when (s)he can expect to receive the card and advise him/her to recontact the FO if it is not received by then.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600901225
HI 00901.225 - Health Insurance Card Inquiries - Allegation of Nonreceipt and FO Action - 02/10/2012
Batch run: 02/10/2012
Rev:02/10/2012