Effective Dates: 10/02/2026 - Present Previous | Next

TN 117 (10-26)

GN 02602.057 Procedure to Reinstate Medicare Advantage (MA) or Medicare Prescription Drug Plan (Part D) After Correcting an Incorrect Death Report

Individuals are disenrolled from their Medicare Advantage (MA) or Medicare Prescription Drug Plan (PDP) when Social Security Administration (SSA) reports a death to the Centers for Medicare & Medicaid Services (CMS). When a disenrolled individual notifies their plan provider of an erroneous disenrollment, CMS instructs the plan provider to direct the individual to SSA to correct the record and to continue to provide benefits until the record is corrected. Disenrollments resulting from incorrect death information are considered invalid and affected individuals must be reinstated into their previous plan, regardless of when the record is corrected.

Follow the procedures in this section when a beneficiary was enrolled in an MA or Part D plan at the time of the incorrect death termination. CMS will reinstate the MA plan or Part D enrollment; however, SSA must reinstate Title II benefits and Medicare Part A and B, and correct SSAs records before requesting CMS to reinstate Part D and MA. (See GN 02602.056, Procedure to Correct an Incorrect Death Record.)

A. Determine if beneficiary has Medicare Part D or MA

If an individual states their plan, or 1-800-MEDICARE, directed them to SSA to correct their record, the referral is likely to be Medicare Part D or MA related. To be sure, ask the individual if they have a Medicare Advantage or Medicare prescription drug plan.

Check the MBR and MAPS (Medicare Application Processing System) (MSOM INTRANETMAPS 006.002, MAPS Development Worksheet Main (DWMP)) to confirm recent Part D or MA enrollment.

NOTE: Part D coverage will not appear in MAPS if a person:

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    Has Medicare prescription drug coverage (PartD) and is not a low-income subsidy (LIS) beneficiary, or

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    Has not filed for LIS and is not paying Part D/Medicare Advantage premium by T2 withholding.

IMPORTANT: Not all Medicare beneficiaries receive Title II cash benefits. Examples of Medicare beneficiaries without Title II cash benefits include:

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    ESRD/CRD (End Stage Renal Disease/Chronic Renal Disease) beneficiaries, see HI 00801.186,

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    MQGE (Medicare Qualified Government Employees), see HI 00801.400,

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    RRB (Railroad Retirement Board) annuitants, see HI 00801.106,

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    EHH (Environmental Health Hazard) beneficiaries, see HI 00803.000

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    Beneficiaries entitled to free Hospital Insurance (HI) who purchase Supplementary Medical Insurance (SMI) and are in direct bill status because they are not currently collecting cash benefits see HI 01001.030, and

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    Beneficiaries not entitled to free HI who purchase HI or SMI, see HI 01005.001.

B. Reinstatement into a Medicare Advantage or Prescription Drug Plan

Take the following steps to reinstate MA or PDP benefits based on individual circumstances.

NOTE: Only a FO manager or a designated technician in the Payment Center (PC) may request CMS to reinstate MA or PDP enrollment.

1. Individual continues to receive coverage through their MA or Part D plan

If an individual indicates that their plan will continue to provide coverage while the incorrect death error is being corrected on their record, provide them with a notice to give to the MA or PDP plan to inform the plan provider that the loss of entitlement was erroneous and the record is being corrected. For samples, see GN 00304.115 Exhibits Notice Language for Erroneous Death Cases.

2. Individual needs life sustaining prescription drugs and is not receiving coverage through their MA or Part D plan

If an individual indicates a need for life sustaining prescription drugs because they are not receiving coverage from their plan provider after correcting the incorrect death on their record, follow these steps:

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    Complete all information on the Medicare Parts C and D Priority Case Referral Tracking Form at https://nynet.ny.ad.ssa.gov/cmsreferral/.

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    Enter Problem Type from the drop-down box as Part A/B erroneously terminated (now reinstated), needs Part D reinstated.

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    Address all the issues in Problem Description including the number of days of medication the beneficiary has left in their possession.

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    Provide individual with a notice to give to the MA or PDP plan to inform the plan that the loss of entitlement was erroneous and the record is being corrected.

NOTE: CMS works with Medicare Part D and MA companies to assign priority to reinstatement requests based on the need of the beneficiary for medication. Therefore, an individual who is out of medication has priority over an individual with 3 weeks of medication left. CMS notifies the requesting FO or PC by email when an individuals Part D or MA is restored.

C. References

GN 02602.056 Procedure to Correct an Incorrect Death Record

MSOM INTRANETMAPS 006.002 MAPS Development Worksheet Main (DWMP)

HI 00801.186 HI Based on End Stage Renal Disease

HI 00801.410 Insured Status Based on MQGE

HI 00801.106 RR Involvement

HI 00803.000 Medicare Entitlement for Individuals Exposed to Environmental Health Hazards (EHH)

HI 03060.005 Priority Case Referals - Medicare Part D (Extra Help) and Medicare Part C (Medicare Advantage) Issues

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202602057
GN 02602.057 - Procedure to Reinstate Medicare Advantage (MA) or Medicare Prescription Drug Plan (Part D) After Correcting an Incorrect Death Report - 10/02/2026
Batch run: 10/02/2026
Rev:10/02/2026