TN 25 (09-93)

A. Policy

1. General

An individual (or proper applicant on his/her behalf) must file an application to be entitled under the deemed insured provision. Except as provided in this section, the regular rules on applications apply (e.g., who may file, what constitutes an application, etc.).

The HCFA-18-F5 (Application for Hospital Insurance Entitlement) is the application specifically designed for establishing deemed insured entitlement. However, all retirement age applications which will be disallowed because the individual is not eligible for such benefits may serve as an application for deemed insured HI.

NOTE: The HCFA-18-F5 is also an application for monthly RSI benefits.

2. Prospective life

An application for deemed insured HI can be effective prospectively for 3 months before the first month all other eligibility requirements are met.

3. Retroactive life

An application for deemed insured HI may be effective for up to 12 months prior to the month of filing but no earlier than the month all other eligibility requirements are met.

4. Withdrawal

The application may be withdrawn at any time. To be effective, the individual must:

• submit a written request for withdrawal, and

• repay any Part A benefits paid on his/her behalf.

B. Reference

See GN 00206.020 for a complete discussion of withdrawal considerations.