When the beneficiary's benefit payments are suspended for a period of time, which
will not permit collection of all premiums due from benefits for the current year,
the beneficiary will be billed and expected to pay the premiums by direct remittance.
For billing instructions if SMI entitlement is initially awarded after the year in
which coverage begins.) When an individual goes from suspense status to deferred status
(i.e., a definite date is set for resumption of benefits), premium billing continues
until benefit payments actually begin. When benefit payments are resumed following
a period of deferred status, any premiums owed are deducted from the first benefit(s)
payable (e.g., where the enrollee has not remitted all premiums timely in response
to direct billing).
Beneficiaries in suspense for an extended period are billed for 3 months' premiums
at a time on a regular quarterly cycle beginning with the first, second, or third
months of the calendar quarter, as explained below.
The billing notices are mailed in the month preceding the quarter. However, the enrollee
may pay premiums for more than one quarter at a time. When a beneficiary pays their
premiums in advance, the direct billing system will not send a bill until the premium
liability exceeds $10.00.
If a beneficiary sends a payment that is less than what was billed, such payments
will be accepted. If the payment received is less than the amount billed and the notice
received was a delinquent notice, a termination will still occur if the remaining
premium liability is more than $10.00.
When the beneficiary's payments are deferred, i.e., a definite date is set for resumption
of benefits, premium billing will occur if the deferred date is not in the current
year. If the deferred date is in the current year, any premiums owed will be deducted
from the first benefit check(s) payable when the benefit payments are resumed.