Identification Number:
HI 00630 TN 1
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Medicare Coverage Outside U.S.
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part HI – Health Insurance
Chapter 006 – Covered Services (HI-SMI)
Subchapter 30 – Medicare Coverage Outside U.S.
Transmittal No. 1, 02/26/2020

Audience

PSC: CS, IES, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, CC, CR, CTE, EIE, ERE, FCR, FDE, PETL, RECONR;
FO/TSC: CS, CS TII, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

This POM is being updated to provide the correct information.

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure

Summary of Changes

HI 00630.030 Developing Foreign RSDI Claims When Claimant May Be Eligible for SMI

Rephrased sentences to comply with plain language techniques (e.g. spelled out acronyms, used active voice, etc.).

Added No 05- before 10043

Deleted SSA Publication No. 05-10005, which describes the limitations on medical insurance coverage for medical expenses incurred outside the United States,

In the last paragraph, last sentence added 05- before 10043.

HI 00630.030 Developing Foreign Retirement, Survivors, and Disability Insurance (RSDI) Claims When Claimant May Be Eligible for Supplementary Medical Insurance (SMI)

SSA must inform claimants who reside outside the United States and are filing for benefits of their right to enroll for SMI coverage if they are within 3 months of attaining age 65 or older and in an enrollment period. In those rare cases in which claimants do not indicate their age but it appears that they may be near or at least age 65, SSA will furnish this information because we might later determine that they are eligible to enroll.

SSA will forward SSA Publications No. 05-10137 “Your Payments While You Are Outside the United States" and No. 05-10043 “Medicare” with the application, and we will annotate the application to show that we sent the publications. We will delete all references to automatic enrollment to SMI from the application.

If claimants file before their initial enrollment period and become eligible to enroll before SSA adjudicates the claim, we will send a supplemental application, as described above, to obtain their election or rejection of SMI coverage. SSA Publications No. 05-10137 and No. 05-10043 will accompany the supplemental application.


HI 00630 TN 1 - Medicare Coverage Outside U.S. - 2/26/2020