Identification Number:
HI 00820 TN 13
Intended Audience:See Transmittal Sheet
Originating Office:Centers for Medicare & Medicaid Services (CMS)
Title:Terminations and Withdrawals
Type:POMS Transmittals
Program:Medicare,Medicaid
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part HI – Health Insurance
Chapter 008 – Requirement for Entitlement and Termination
Subchapter 20 – Terminations and Withdrawals
Transmittal No. 13, 11/19/2020

Audience

PSC: BA, CA, CS, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, BIES, CR, EIE, ERE, FCR, PETL, RECONR;
OCO-ODO: BET, BTE, CCE, CR, CST, CTE, CTE TE, DEC, DSE, LCC, PAS, PETE, PETL, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

CMS

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal and does not introduce policy or new procedure.

Summary of Changes

HI 00820.001 Introduction - Terminations and Withdrawals

updated POMS with reference HI 00801.145

HI 00820.001 Introduction - Terminations and Withdrawals

A. POLICY - TERMINATION

Medicare entitlement continues until the occurrence of a legally prescribed terminating event. The terminating events differ among the various HI entitlement provisions and for SMI.

B. POLICY - WITHDRAWALS

HI for insured individuals, including R-HI beneficiaries, can be annulled through withdrawal of the application (either monthly benefit or HI only) which resulted in the establishment of HI entitlement. As explained in GN 00206.095B.1.c., any HI benefits paid between entitlement and withdrawal must be repaid before the withdrawal can become effective. Withdrawal from SMI and Premium-HI can only occur under the circumstances described in HI 00801.145 and HI 00805.080.

C. POLICY - EFFECT OF MONTHLY BENEFIT WITHDRAWAL ON HI

An individual age 65 or over may withdraw an application for monthly RSI benefits without loss of HI. However, an individual under age 65 who withdraws an application for monthly disability benefits also loses HI and SMI. SMI terminates at the end of the month the individual is notified that the withdrawal has been approved.


HI 00820 TN 13 - Terminations and Withdrawals - 11/19/2020