TN 23 (04-01)

HI 00805.265 The Special Enrollment Period -- Definition

A. Definition

The Social Security Act amendments provide for the special enrollment period (SEP) beginning 11/84 for the working aged and 1/87 for the disabled. The SEP is the period for enrollment in SMI and/or Premium-HI that is provided for individuals who:

  • are eligible for SMI and/or Premium-HI on the basis of age or as disabled beneficiaries, and

  • have been (or are currently) covered by a group health plan (GHP) or a large group health plan (LGHP) based on current employment status.

NOTE: Individuals with end-stage renal disease (ESRD) are not eligible for the SEP or premium surcharge rollback. This includes individuals who are dually-entitled to Medicare based on ESRD and age or disability.

B. Reference

See HI 00805.300 for definition of the Disability SEP

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HI 00805.265 - The Special Enrollment Period -- Definition - 04/11/2001
Batch run: 06/08/2015