An SSI recipient, with an established onset date of 06/01/1990, becomes entitled to
disability insurance benefits (DIB) based on his date first insured of 04/1991.
His wife passed away in 01/1992.
During an SSI redetermination, he files a DWB application in 01/1993. Based on the
adoption of the Title XVI determination, onset for DWB is established as 06/01/1990.
Since he did not file until 01/1993, the DWB MOE is restricted by the date of death
to 01/1992 (12 months retroactivity). Before this provision, considering only the
DWB entitlement, Medicare would be effective 01/1994, based on a 24-month qualifying
period.
Proceed as follows:
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1.
From reviewing the CMPH field of the SSR, 06/1990 is the first C01 month with a dollar
amount other than zero. The crediting period begins here.
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2.
Apply his SSI/SSP credit months beginning 06/1990.
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3.
Considering his DWB entitlement only, the regular Medicare effective date is 01/1994
after serving the 24-month qualifying period. However, after crediting SSI/SSP months
to the qualifying period, the Medicare effective date becomes:
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06/1990 plus 24 months = 06/1992.
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4.
Record the information on the appropriate MCS screens.
NOTE: In this example, note the difference in Medicare effective dates because of the SSI
credit months:
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•
Effective date for Medicare after SSI credit months: 06/1992.
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•
Effective date for Medicare due to DIB: 09/1993.
Due to the DWB entitlement, the claimant will be entitled to Medicare fifteen months
earlier than he otherwise would have been based solely on his DIB entitlement.