To participate in the pilot, EHH Medicare beneficiaries must be entitled to Medicare
Part A (HI) and Part B (Supplementary Medical Insurance, SMI) and currently reside
within one of the following ZIP codes in the states of Idaho, Montana or Washington.
Idaho ZIP codes:
83520
|
83804
|
83815
|
83832
|
83843
|
83853
|
83866
|
83877
|
83535
|
83805
|
83816
|
83833
|
83844
|
83854
|
83867
|
|
83537
|
83806
|
83821
|
83834
|
83845
|
83855
|
83868
|
|
83541
|
83808
|
83822
|
83835
|
83846
|
83856
|
83869
|
|
83544
|
83809
|
83823
|
83836
|
83847
|
83857
|
83870
|
|
83546
|
83810
|
83824
|
83837
|
83848
|
83858
|
83871
|
|
83553
|
83811
|
83825
|
83839
|
83849
|
83860
|
83872
|
|
83801
|
83812
|
83826
|
83840
|
83850
|
83861
|
83873
|
|
83802
|
83813
|
83827
|
83841
|
83851
|
83864
|
83874
|
|
83803
|
83814
|
83830
|
83842
|
83852
|
83865
|
83876
|
|
Montana ZIP codes:
59411
|
59808
|
59834
|
59856
|
59873
|
59915
|
59926
|
59936
|
59417
|
59812
|
59842
|
59859
|
59874
|
59916
|
59927
|
59937
|
59427
|
59820
|
59844
|
59860
|
59901
|
59917
|
59928
|
59941
|
59434
|
59821
|
59845
|
59863
|
59903
|
59918
|
59929
|
|
59801
|
59823
|
59846
|
59864
|
59904
|
59919
|
59930
|
|
59802
|
59824
|
59847
|
59865
|
59910
|
59920
|
59931
|
|
59803
|
59825
|
59848
|
59866
|
59911
|
59921
|
59932
|
|
59804
|
59826
|
59851
|
59867
|
59912
|
59922
|
59933
|
|
59806
|
59830
|
59853
|
59868
|
59913
|
59923
|
59934
|
|
59807
|
59831
|
59855
|
59872
|
59914
|
59925
|
59935
|
|
Washington ZIP codes:
99001
|
99020
|
99039
|
99121
|
99143
|
99160
|
99201
|
99216
|
99003
|
99021
|
99040
|
99122
|
99144
|
99161
|
99202
|
99217
|
99004
|
99022
|
99101
|
99125
|
99146
|
99163
|
99203
|
99218
|
99005
|
99023
|
99102
|
99126
|
99147
|
99164
|
99204
|
99219
|
99006
|
99025
|
99103
|
99128
|
99148
|
99166
|
99205
|
99220
|
99008
|
99026
|
99104
|
99129
|
99149
|
99167
|
99206
|
99223
|
99009
|
99027
|
99107
|
99130
|
99150
|
99170
|
99207
|
99224
|
99011
|
99029
|
99109
|
99131
|
99151
|
99171
|
99208
|
99228
|
99012
|
99030
|
99110
|
99134
|
99152
|
99173
|
99209
|
99251
|
99013
|
99031
|
99111
|
99136
|
99153
|
99174
|
99210
|
99252
|
99014
|
99032
|
99113
|
99137
|
99154
|
99176
|
99211
|
99256
|
99016
|
99033
|
99114
|
99138
|
99156
|
99179
|
99212
|
99258
|
99017
|
99034
|
99117
|
99139
|
99157
|
99180
|
99213
|
99260
|
99018
|
99036
|
99118
|
99140
|
99158
|
99181
|
99214
|
99299
|
99019
|
99037
|
99119
|
99141
|
99159
|
99185
|
99215
|
99333
|
EHH Medicare beneficiaries who do not live in the ZIP codes listed above are eligible
to participate in the Pilot Program if they:
-
•
are entitled to EHH Part A (HI) and Part B (SMI),
-
•
previously resided in one of the ZIP codes listed on or after July 1, 2011,
-
•
have since moved out of the Pilot Program area, and
-
•
apply to participate in the Pilot Program by March 30, 2015.
As part of the enrollment application to participate in the pilot, the beneficiary
will need documentation to show proof of current or previous residency in one of the
listed ZIP codes.
EHH beneficiaries with HI and SMI, living in the expanded service area, can sign up
for the pilot starting March 1, 2014.
EHH beneficiaries with HI only, living in the expanded service area must enroll in
SMI prior to signing up for the pilot. Beneficiaries may enroll in SMI during their
initial enrollment period, the general enrollment period, or the special enrollment
period, as described in HI 00803.220.
NOTE: EHH beneficiaries residing in these ZIP codes will be eligible for the SMI special
enrollment period (SEP) described HI 00803.220.
NOTE: Individuals not already enrolled in SMI and not currently residing in the listed
ZIP codes are not eligible for the EHH SEP described in HI 00803.220.