TN 74 (02-23)

HI 00805.007 SMI Eligibility for Foreign Residents

A. Policy - Foreign residents who are eligible for premium-free HI

A person who resides outside the U.S. is eligible to enroll in SMI only if the person is eligible for HI. This is because a foreign resident cannot meet the U.S. residence requirement in HI 00805.005 A.2., even if the person is a citizen of the United States.

The SMI IEP for foreign residents who are eligible for HI is determined based on the month in which the foreign resident could have become entitled to HI if the foreign resident had filed an application for HI entitlement.

EXAMPLE: William McGee resides in France. William was fully insured when William attained age 65 in 7/89. William's IEP, therefore, was 4/89 through 10/89. Because William was working full time, William did not enroll for social security at that time. When William retired in 1/91, William requested cash benefits, HI and SMI, as William was returning to the U.S. shortly.

William was awarded monthly benefits and HI as of 7/90, with SMI effective 7/91 based on the GEP enrollment, see HI 00805.025. The SMI premium rate was increased 10 percent because 17 months elapsed after the end of William's IEP (based on eligibility for HI) through the end of the 1991 GEP (no employer group health plan coverage involved).

B. Policy - Foreign residents who are U.S. citizens and not eligible for HI

A U.S. citizen, age 65 or over, who is a foreign resident and is not eligible for HI is first eligible to enroll in SMI with the month in which the U.S. citizen returns to residence in the U.S. The IEP for a U.S citizen not eligible for HI must be based on an alternate requirement. (See HI 00805.005 A. 2. which requires U.S residence in the absence of HI entitlement.) The month in which the U.S. citizen, age 65 or over, establishes U.S. residence is the fourth month of the IEP, see HI 00805.015.

EXAMPLE: Lily Lee, born February 1919 in the U.S., has lived in Canada since Lily married in 1939. Neither Lily nor Lily's spouse ever worked in employment covered by the Social Security Act. Lily retained Lily's U.S. citizenship and returned to reside in the U.S. in June 1991.

Although Lily is 72 years old, June 1991 is the fourth month of Lily's IEP (i.e., the month Lily is first eligible for SMI).

NOTE: If Lily does not enroll in Lily's IEP, but enrolls in a subsequent GEP, the premium surcharge for late enrollment in SMI is determined, as usual, by counting months after Lily IEP (3/91 through 9/ 91).

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HI 00805.007 - SMI Eligibility for Foreign Residents - 02/02/2023
Batch run: 02/02/2023