HI 01001.090: Receipt of Premiums in the Field Office (FO)
Effective Dates: 01/31/2018 - Present
- TN 22 (11-01)
- HI 01001.090 Receipt of Premiums in the Field Office (FO)
- If the enrollee wishes to make premium payments in the FO, the following procedures apply: (See GN 02403.000 for general processing of receipts.)
- A. Procedure - initial premium payment in connection with current enrollment
- If a payment is received before the Supplementary Medical Insurance (SMI) award is prepared, the premium remittance and the mailing envelope should be annotated in red ink "PREPAYMENT" and forwarded to the Medicare Premium Collection Center (MPCC) (See HI 01001.090B. for address.) The MPCC has specific instructions for processing these payments. Follow procedure in GN 02403.007 for providing a receipt for the premium payment.
- B. Procedure - payment other than initial premium payment
- Payment of premiums in the FO should be discouraged for the reasons given in HI 01001.025B. If the enrollee offers to pay his/her premiums in the FO, explain the advantages of paying his/her future premiums directly to the Medicare Premium Collection Center. Payment by mail will save the time and expense of visiting the FO and saves the Government considerable expense. It is important to hold down administrative costs because it is one of the elements in calculating the amount of premiums each year. Payments received in the FO could delay the payment process by at least 5-7 days. Additionally, credit card payments cannot be accepted in the SSA field office or accepted over the phone.
- However, if the enrollee prefers to pay the premiums in the FO, accept the payment and prepare an automated receipt (see GN 02403.030). The Medicare Number must be clearly shown on check/money order. If the CMS-500 is available, forward the bottom portion of the CMS-500 along with the remittance to:
- Centers for Medicare & Medicaid Services
- Medicare Premium Collection Center
- P.O. Box 790355
- St. Louis, MO 63179-0355
Provide the enrollee with a copy of the receipt. It is the responsibility of the FO to follow up on the premium payment if it is not shown on the direct billing record within 30 days. Use the processing or post mark date and the amount of premium payment to verify the entry on the direct billing record, Health Insurance/Supplementary Medical Insurance Query Reponse (HIQR). The follow-up inquiry should be directed to:
- Centers for Medicare & Medicaid Services
- Premium Collection Branch
- 7500 Security Boulevard
- Baltimore, MD 21244-1850
- If the entry is on the direct billing record, no action is necessary. If the remittance is not reflected on the current HIQR, Medicare Premium Payment Query (MPPQ), develop the case as a premium problem and forward to the address above. Attach all necessary information, including a copy of the current direct billing screen and a copy of the canceled check.
- If a husband and wife, both SMI enrollees, remit SMI premiums for both in a single check or money order, the premium payment may be recorded on a single receipt providing both names and Medicare numbers. The names of both beneficiaries and both Medicare numbers must clearly be shown on the check or money order. If the premium remittance was received in cash, a separate receipt should be made out for each enrollee.
- C. Procedure - receipt of cash
- Cash payments are not to be encouraged. However, if cash payments are offered they will be accepted, converted daily into checks or money orders, and forwarded with appropriate CMS-500 in accordance with section HI 01001.090. Cash is not to be held overnight.
- D. Procedure - receipt of Explanation of Medicare Benefits (EOMB) or Medicare Summary Notice with remittance for premium arrearage
- All EOMBs that are received in the FO from carriers along with checks made payable to Medicare Insurance for premium arrearages should be forwarded to the Medicare Premium Collection Center for processing. This should be very rare.
x← This means that the line was removed and was added – in other words, the "Effective Dates" line at the top of the document has been updated to reflect that the new version is effective as of the date the change was made.