If, after the cut-off date for reinstatement but during the extended period, the enrollee
submits a payment to cover the premiums due through the end of the initial or extended
grace period, but without a good cause explanation, accept the payment and send the
following notice:
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“We have received and credited to your account your recent premium payment of $ for months ending . Your premium payment was received too late to prevent termination of your SMI coverage
effective . However, your coverage may be reinstated if there was good cause for your failure
to pay your premiums before that date. If you believe there was good cause for such
failure, and wish to retain your SMI coverage, please contact your local social security
office within the next thirty days. They will ask you to explain why your payment
was delayed (and will also ask you to pay any premiums now overdue if your coverage
is reinstated).
You should have this letter with you when you contact that office.”
NOTE: Omit the parenthetical clause about payment of additional overdue premiums if the
enrollee is a beneficiary in suspense, or if the enrollee has already paid all premiums
currently due (through the extended grace period).
To have coverage reinstated request such relief and establish good cause within one
month (A) of the date of the letter from the reviewing office, or if later, (B) the
end of the extended grace period. If the reviewing office has heard nothing further
from the DO or the enrollee two months after such date, refund any excess premiums
(for months after the initial grace period) to the enrollee.