HI 00630.040 Processing Claims Involving Possible Coverage Under The Health Insurance Programs for Individuals at Least Age 65 Who Are Not Entitled to Monthly Benefits

Under the provisions of the Social Security Act, it is possible for an individual who is at least age 65 and not eligible for monthly RSDI benefits to become entitled to hospital insurance and/or to be eligible for enrollment in the SMI program if he meets certain requirements. (See HI 00801.061, HI 00801.131 and HI 00805.005 regarding alien nonbeneficiaries.) Providing the claimant has not declined enrollment in SMI, development for possible health insurance protection should be undertaken in all cases in which it appears the claimant, although not eligible for monthly Social Security benefits, is a resident of the United States and is at least age 65. (See HI 00801.047, HI 00801.126 and HI 00805.005 for development guides.)

If it appears the claimant is not a resident of the U.S., no further action regarding health insurance need be taken. The system will generate paragraph MG26 on the disallowance notice.