Basic (03-86)
DI 45001.087 Subsequent Determination of Deferred Decision, Approval of Earlier R-HI/ R-SMI Entitlement
Based on Self-Dialysis Training
You were previously advised that we would notify you later if your medicare coverage
could begin at an earlier date. It has been determined from the information given
to the Social Security Administration about your training in self-care dialysis that
you need not serve the qualifying period before your Medicare coverage based on kidney
dialysis treatment can begin. Your entitlement to hospital insurance coverage has,
therefore, been changed to begin , and your entitlement to medical insurance coverage has been changed to begin .
This notice replaces the information on the Medicare card (or notice) you previously
received. A card will be mailed to you showing your new earlier Medicare effective
dates. In the meantime, if you require hospital or medical services or there is a
question raised about the coverage of your previous services, you may use this notice
as proof of entitlement. Your old medicare card should be destroyed as soon as you
receive a new one with the above dates of your coverage.
If you have any questions about your coverage or should your condition no longer require
a regular course of dialysis treatment, please contact the people at any social security
office.
If you believe this determination is not correct, you may request that your case be
reexamined. If you want this reconsideration, you must request it not later than 60
days from the date you receive this notice. You may make your request through any
social security office. If additional evidence is available, you should submit it
with your request.