TN 18 (02-16)

HI 03010.020 Leads and Protective Filing

Citations:

20 CFR 418.3230

Technicians can establish a subsidy application filing date based on a written or oral indication of intent to file, including an appointment for an initial claim made via the National 800 Number Network (N8NN) or a partially completed Internet Application for Extra Help with Medicare Prescription Drug Plan Costs (i1020). See HI 03010.015 for policy for determining the application filing date.

A. Establishing a protective filing

1. Criteria for establishing a protective filing

a. The claimant must be a proper applicant

A proper applicant is the claimant or his or her personal representative. See HI 03010.010B for the definition of “personal representative” for purposes of the Extra Help subsidy.

b. There must be an intent to file

Intent to file for the subsidy may be made orally or in writing. A partially completed i1020 meets the intent to file requirement. The start date for the partial i1020 is available using the I-Main menu by clicking on the “i1020 Internet Query” link.

c. Intent to file document must be filed with the Social Security Administration (SSA)

A beneficiary may establish a protective filing:

  • at an SSA office,

  • with an SSA employee on official duty at a place other than an SSA office, or

  • by partially completing an i1020 online via SSA’s online website (socialsecurity.gov).

2. Applications used to establish protective filing

a. Applications submitted by State Medicaid agencies

SSA will use the date the State annotates on the SSA-1020 (Application for Extra Help with Medicare Prescription Drug Plan Costs) when applications are submitted by State Medicaid agencies. The State Medicaid agency will follow the Centers for Medicare & Medicaid Services’ instructions regarding protective filing.

b. Title II application with Medicare involvement

When you take a Title II application for a claimant who is entitled to or filing for Medicare, you must follow the interviewing guidelines in HI 03010.005B when determining subsidy eligibility.

If the claimant wants to file a subsidy application, take the application and promptly closeout the protective filing.

If the claimant does not want to file a subsidy application, issue a closeout notice per HI 03010.030. After the issuance of the closeout notice, document the Modernized Claims System (MCS) Development Worksheet (DW01) with the Title XVIII closeout issue and enter the date you issued the closeout notice in the REC field.

NOTE: If the claimant files an internet claim (iClaim) and does not want to file for the subsidy, no further action (recontact or closeout) is necessary.

c. Subsidy application and Supplemental Security Income (SSI) implications

A filed subsidy application is also a protective filing for SSI benefits. The subsidy award or denial notice includes an SSI protective filing closeout paragraph. No additional closeout notice is necessary.

NOTE: If an SSI claim is completed and we based the protective filing date on a scanned SSA-1020 mailed to the Wilkes-Barre Direct Operations Center or an i1020, Field Offices (FOs) may enter ZZZ in the unit field to exclude the case from processing time counts.

B. Documenting a protective filing

Technicians must document a protective filing date either via the 800# System Worksheet or MCS. For the protective filing closeout notice requirements, see HI 03010.030.

1. N8NN instructions

See TC 24020.020 for N8NN instructions for Medicare prescription drug subsidy eligibility and filing information.

  • If the claimant expresses an intent to file an application and is willing to complete a paper application, follow instructions in TC 10003.010.

  • If the claimant expresses an intent to file an application and the Workload Support Unit exclusions do not apply, follow the procedure in TC 10008.020B.

  • If the claimant expresses an intent to file an application and the Workload Support Unit exclusions apply, follow the procedure in TC 10010.070.

2. FO instructions when claimant wants to delay filing a subsidy application

If the claimant