TN 107 (06-24)

HI 00805.153 Prior Month Attainment Rule

Policy for prior month attainment rule

A deemed IEP may be established for an individual born on the first day of a month a person files an enrollment request in the first month after the IEP.

Since individuals born on the first day of a month are ordinarily unaware that they actually attain a given age in the preceding month, the deemed IEP provision will be applied without further development.

IMPORTANT: If there is evidence in file that demonstrates that the enrollee knew the “prior-month” attainment rule, do not establish a deemed IEP.


IEP occurring before January 1, 2023 - John Allen DB 3/1/1920, enrolled on 6/22/1985. Although John's enrollment request was filed in the month after expiration of John's actual IEP, a deemed IEP of 12/1984-6/1985 is established and SMI coverage is effective 9/1/1985. If John had enrolled in 3/1985, John's SMI coverage would be effective 5/1/1985, see HI 00805.165B.2. A deemed IEP could not be established since John enrolled during the actual IEP.

IEP occurring on or after January 1/2023 - Allen Grady turned 65 5/1/2023 and enrolled on 8/28/2023. Since Allen filed for enrollment request after the end of this IEP, Allen’s is given a deemed IEP of 4/2023-8/2023. Allen’s SMI would be effective 9/2023, see HI 00805.165B.1.

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HI 00805.153 - Prior Month Attainment Rule - 06/03/2024
Batch run: 06/03/2024