Extended Medicare coverage, effective October 2000 provides 78 months of extended
Medicare eligibility to persons whose disability ceased due to SGA and continue to
have a disabling impairment.
Counting the first 15 months of the EPE, this provision allows for continued premium-free
hospital insurance (HI), and supplemental medical insurance, for at least 93 months after the TWP. (In extending the reinstatement period from 15 to 36 months, Congress
stipulated that, for Medicare purposes, we must treat the reinstatement period as
though it was still 15 months. That is, the beginning date of extended Medicare coverage
did not change along with the lengthening of the reinstatement period. As a result,
the start of the Medicare extension often occurs before the BTM). Generally, coverage
ends 78 months after the first month of SGA occuring after the 15th month of the EPE,
but never before the BTM.
The policies and procedures for determining whether a person continues to have a disabling
impairment for Medicare purposes are essentially the same as for EPE cases.