TN 30 (03-96)
NL 00703.602 SMI — Reenrollment During the GEP After Prior Enrollment Terminated
Document Identifier for Word Process: E3602
A. EXHIBIT LETTER
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.
B. GENERAL INSTRUCTIONS
Exhibit NL 00703.602 is used when a beneficiary attempts to enroll after a prior enrollment has been terminated. This is notification that the enrollment should be made during the GEP.
Refer to NL 00703.005E. for 3901C text.
C. TYPING INSTRUCTIONS
Information for this letter will be shown on Form SSA-573. The name and address, if not given, can be taken from the latest Form SSA-3926-EP in file.