Billing notices are prepared according to premium information carried in the Direct
Billing System (DBS). Premium payments are due by the 25th of the month the bill is mailed.
If beneficiary has made an advance premium payment for a quarter, a subsequent billing
notice for future billing will not occur until the beneficiary's premium liability
is $10.00 or more. However, if the beneficiary submits a payment shortly before the
billing selection date, it is likely they will receive a billing notice, as the payment
is still in the processing stages.
Example: Martin, an "M" beneficiary, is on a quarterly "A" billing cycle. Martin is billed
in January. Martin paid their premiums in February for 8 months (February through
September). Martin should not receive a bill in April. However, their next bill should
be sent in July for premiums due for 1 month, October. The due date of all billing
notices is the 25th of the month.
Explain to the beneficiary the importance of prompt payment of Supplementary Medical
Insurance (SMI) premiums; i.e., payment should be made upon receipt of the bill; and
failure to pay premiums timely may result in termination of SMI coverage. Tell the
beneficiary when coverage is expected to start and that they may receive the billing
notice within 30 days after receipt of the SMI award notification. If the notice or
other advice is not received within 60 days after the beginning of SMI coverage, the
beneficiary should contact the field office regarding their SMI premium billing. Inform
the beneficiary about the rules in HI 01001.025 concerning payment by remittance since
those rules apply regardless of whether the premium is being paid by the enrollee
or by someone on their behalf.
Information regarding the grace period should not be provided to the enrollee unless
specifically requested. Otherwise, the enrollee may be inclined to put off making
the payment until later or may even forget making the payment, causing termination
of the enrollee's coverage and loss to the trust fund. In this event, the enrollee
loses the real advantage of the long grace period. For example, if an emergency arises
which prevents the enrollee from making payments when due, the enrollee has an extra
2 months, if necessary, in which to catch up.