An individual is entitled to HI based on exposure to EHH if the individual meets all of the following criteria:

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  diagnosed with an asbestos-related disease (ARD) established by certain diagnostic methods. For instructions on developing this medical requirement, see HI 00803.050; and

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  present in Lincoln County, Montana, for a total of at least 6 months (need not be consecutive) in the period ending 10 years or more before diagnosis of an ARD and prior to the implementation of all the remedial and removal actions specified by the Environmental Protection Agency in Records of Decision for Libby and Troy, Montana. Since all remedial and removal actions have not been completed, there is no end date to establishing presence at this time. For instructions on developing this presence requirement, see HI 00803.040; and

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  filed an application for HI.

There are no age or insured status requirements.

If the claimant meets both the presence and medical requirements as of the date of filing (DOF), or by the end of the month of filing, HI will be effective the first day of the month following the month of filing. If a physician has not diagnosed the claimant with a qualifying ARD as of the DOF or by the end of the month of filing, the effective date of HI will be the first day of the month after the month the claimant is diagnosed with a qualifying ARD if the claimant also meets the presence requirement in HI 00803.001B.1. second bullet in this section.

Example 1:

Mary Jackson applied for EHH Medicare on May 12, 2010. A completed EHH Checklist confirmed Mary Jackson received an ARD diagnosis established by a diagnostic method specified in the law on April 4, 2010, and that Mary Jackson met the presence requirement. Mary Jackson's HI entitlement began June 1, 2010.

Example 2:

Larry James applied for EHH Medicare on July 12, 2010. As of the filing date, Larry James had not received an ARD diagnosis. In the same month, on July 22, Larry James received an ARD diagnosis established by a diagnostic method specified in the law. A completed EHH Checklist confirmed the diagnosis and that Larry James met the presence requirement. Larry James' HI entitlement began August 1, 2010.

Example 3:

Steve Brown applied for EHH Medicare on May 12, 2010. As of the filing date, Steve Brown had not received an ARD diagnosis. On June 1, Steve Brown received an ARD diagnosis established by a diagnostic method specified in the law. A completed EHH Checklist confirmed the diagnosis and that Steve Brown met the presence requirement. Steve Brown's HI entitlement began July 1, 2010.

There is no retroactivity for Medicare eligibility under this provision.

Normal protective filing rules apply to EHH Medicare claims but cannot extend before March 23, 2010. For more information on protective filing and leads for EHH Medicare refer to HI 00803.020.