Beneficiaries age 65 or older or under age 65 and covered under a GHP based on the current employment status of a domestic (or life) partner are not spouses for SEP and premium surcharge rollback purposes. (For the definition of spouse and GHP, see HI 00805.266A.) However, under the equitable relief provisions, we permit these beneficiaries to enroll in Supplementary Medical Insurance (SMI) and premium Hospital Insurance (premium-HI) as if the SEP provisions still apply. Grant equitable relief to individuals who:

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  Are age 65 or older or under age 65 and covered under a GHP based on the current employment status of a domestic (or life) partner and

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  refused SMI (or did not enroll in premium-HI) and whose initial enrollment period (IEP) begins 12/2004 or earlier or enrolled in SMI (or premium-HI) during the IEP and voluntarily terminated coverage prior to 12/2004.

Joe Jones attained age 65 in November 2004. Joe refused SMI coverage because Joe was covered under Joe's partner’s group health plan (GHP). Joe's partner, Tim Smith, is working and the GHP includes domestic partner within the definition of spouse.

In October 2011, Joe contacts an SSA FO about enrolling in SMI because Joe's partner is retiring January 1, 2012.

Since, we cannot recognize a domestic partner, age 65 or older, as a spouse, the SEP provisions no longer apply. Because Joe's IEP begins 08/2004, Joe can enroll in SMI under the equitable relief provisions. Joe may enroll during any month in which the coverage under GHP which is based on Joe's partner’s current employment or during the 8-month period that begins with the first full month after the GHP coverage based on current employment ends.

HI 00805.266 Definitions of Terms Used in the Special Enrollment Period and Premium Surcharge Rollback Provisions