Some examples of when withdrawal an EHH Medicare application may occur are:

• •

  Medicare is the secondary payer of benefits and the beneficiary discovers after HI and SMI are in effect that the employer plan will pay all expenses;

• •

  there is another insurance that is primary to Medicare or will pay all medical expenses; or

• •

  the beneficiary requires Part B coverage but does not meet the requirements for a special enrollment period (SEP).

Upon withdrawal of the EHH Medicare application, EHH HI terminates retroactive to the first month of HI entitlement.

If the beneficiary files a withdrawal request within 60 days of the notification of EHH HI and SMI entitlement, EHH SMI terminates retroactive to the first month of SMI entitlement. If the beneficiary files a request for withdrawal after the 60-day period, EHH SMI terminates at the end of the month in which SSA notifies the beneficiary of approval of the request for withdrawal. SMI premiums paid for the period of entitlement are not refundable.

If the beneficiary is entitled to Medicare based on age, disability or ESRD, that coverage continues.

Treat a subsequent application for EHH Medicare as an initial application. The claimant has a new initial enrollment period (IEP) for SMI based on the month of HI entitlement. If the claimant does not refuse SMI, SMI is effective the month of HI entitlement without a premium surcharge for late enrollment.