This is in regard to your application for medical insurance coverage.
The Social Security Act provides certain periods during which an individual may enroll
for medical insurance protection. Since your prior enrollment has been terminated,
you may reenroll only during January, February and March of any subsequent year. Your
medical insurance would be reinstated the following July 1.
If you believe that this determination is not correct, you may request that your case
be reexamined. If you want this reconsideration, you must request it not later than
60 days from the date you receive this notice. You may make any such request through
any Social Security office. If additional evidence is available, you should submit
it with your request.