TN 17 (10-00)

HI 01005.804 Premium Collection for Uninsured Beneficiaries

A. POLICY-General

The grace period ends on the last day of the month in which the delinquency notice is received (90 days from the initial bill) unless an extended grace period is given (See HI 01001.355). For premium HI beneficiaries the grace period will end on the last day of the month in which the second delinquent notice is received (90 days from the initial bill) or unless an extended grace period is given. (See reference above.) When a combined billing notice is issued, a preexisting SMI grace period is combined with the HI grace period. (See HI 01005.015C). There is no grace period for third party group billing.

B. POLICY--Method of Premium Collection

1. SMI Only

Billed quarterly (every 3 months) (HI 01001.045). Monthly billing is possible, if the enrollee prefers. As an individual is accreted to the Direct Billing System, their billing notice will be included in the next available bill cycle selection. The initial billing notice includes premium amounts due for the 3 months following the billing date and may include premiums due for any prior coverage months. The enrollee may authorize group payment by a third party.

2. HI and SMI

Billed monthly. SMI and HI premiums are combined on the billing notice. When a combined billing notice is issued to add HI to an existing SMI coverage, the new SMI grace period begins based on the combined billing month.

3. Third Party Groups

Monthly billing. A third party group may pay either the entire monthly premium amount (See HI 01001.230) or pay the premium surcharge portion of the premium (See HI 01001.271). If the third party group (State or Local Government) is paying just the surcharge the enrollee may have the base premium withheld from the benefit checks or may be directly billed. NOTE: Premium payments made by either a State or other official group payer are not reflected on the Direct Billing System. They are controlled by the Third Party System.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0601005804
HI 01005.804 - Premium Collection for Uninsured Beneficiaries - 10/31/2000
Batch run: 01/27/2009
Rev:10/31/2000