TN 19 (03-93)

HI 00805.006 Enrollee Ceases to Meet Eligibility Requirements


Once an individual is properly enrolled in SMI, failure to continue to meet the eligibility requirements does not cause termination of enrollment. Valid SMI coverage may be terminated only in accordance with provisions set out in HI 00820.035.

However, to be able to reenroll after termination of coverage, the individual must be eligible as defined in HI 00805.005 A.

EXAMPLE: Mrs. Smith, who was receiving aged wife's insurance benefits when she reached age 65, enrolled timely for SMI. She divorced the NH but was not entitled to divorced wife's monthly benefits as she had been married to him less than 10 years. She was not entitled to any other RSDI benefit nor eligible for HI under the deemed insured provision. She was not a citizen of the U.S. nor had she lived in the U.S. continuously for the 5 preceding years.

Although her entitlement to monthly benefits and HI terminates, Mrs. Smith continues to be covered by SMI.

NOTE: If Mrs. Smith's SMI entitlement ends, she must meet the requirements in HI 00805.005 to reenroll in SMI.

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HI 00805.006 - Enrollee Ceases to Meet Eligibility Requirements - 03/17/1993
Batch run: 04/23/2015