TN 19 (03-93)

A. Policy - Foreign residents who are eligible for premium-free HI

A person who resides outside the U.S. is eligible to enroll in SMI only if he /she is eligible for HI. This is because a foreign resident cannot meet the U.S. residence requirement in HI 00805.005 A.2., even if he/she is a citizen of the United States.

The SMI IEP for foreign residents who are eligible for HI is determined based on the month in which they could have become entitled to HI if they had filed an application for HI entitlement.

EXAMPLE: William McGee resides in France. He was fully insured when he attained age 65 in 7/89. His IEP, therefore, was 4/89 through 10/89. Because he was working full time, he did not enroll for social security at that time. When he retired in 1/91, he requested cash benefits, HI and SMI, as he was returning to the U.S. shortly.

He was awarded monthly benefits and HI as of 7/90, with SMI effective 7/91 based on the GEP enrollment (see HI 00805.025). The SMI premium rate was increased 10 percent because 17 months elapsed after the end of his IEP (based on eligibility for HI) through the end of the 1991 GEP (no employer group health plan coverage involved).

B. Policy - Foreign residents who are U.S. citizens and not eligible for HI

A U.S. citizen, age 65 or over, who is a foreign resident and is not eligible for HI is first eligible to enroll in SMI with the month in which he/she returns to residence in the U.S. The IEP for a U.S citizen not eligible for HI must be based on an alternate requirement. (See HI 00805.005 A. 2. which requires U.S residence in the absence of HI entitlement.) The month in which the U.S. citizen, age 65 or over, establishes U.S. residence is the fourth month of the IEP. (See HI 00805.015.)

EXAMPLE: Lily Lee, born February 1919 in the U.S., has lived in Canada since she married in 1939. Neither she nor her husband ever worked in employment covered by the Social Security Act. Mrs. Lee retained her U.S. citizenship and returned to reside in the U.S. in June 1991.

Although Mrs. Lee is 72 years old, June 1991 is the fourth month of her IEP (i.e., the month she is first eligible for SMI).

NOTE: If Mrs. Lee does not enroll in her IEP, but enrolls in a subsequent GEP, the premium surcharge for late enrollment in SMI is determined, as usual, by counting months after her IEP (3/91 through 9/ 91).