POMS Reference

HI 01001: Supplementary Medical Insurance

TN 22 (11-01)

Payment of past-due premiums from a prior period of coverage is not a prerequisite for reenrollment for the individual. The enrollee's current enrollment is not affected by his/her failure to pay premiums owed for a past period of coverage.

A. PROCEDURE--ENROLLEE PAYS PREMIUMS IN PERSON

If the enrollee visits the field office (FO) to reenroll, advise him/her that if he/she owes premiums for a prior period of coverage, he/she is still obligated to pay and he/she should pay them promptly. These premiums, if not previously paid will be deducted from subsequent monthly benefits payable to him/her. Should he/she offer a payment to the FO, suggest that the payment be credited to his/her prior period of coverage and identify it as payment for the enrollee's prior period of coverage. If he/she objects, honor his/her wish and identify the payment for the prospective period of coverage. Forward it to the servicing program service center (PSC) for appropriate crediting.

B. PROCEDURE--ENROLLEE PAYS PREMIUMS BY MAIL

When an individual owes premiums from a prior period of coverage and pays premiums at or after the time he/she reenrolls, such premiums will be credited to whichever period he/she specifies. Where he/she fails to specify how the premiums should be applied, they are credited to the new period of coverage. Any implied indication to the contrary should be respected. For example, if an uninsured beneficiary returns any type of notice of premium due from the past period of coverage (billing notice, letter, or termination notice) along with a remittance, this can be interpreted as expressing intent to settle his/her existing premium indebtedness. The premiums should be credited accordingly.

C. PROCEDURE--ENROLLEE OBJECTS TO THE WAY PREMIUMS WERE CREDITED

Records of premiums paid in connection with reenrollments will be retained by the servicing PSC for a reasonable period of time. This will permit re-crediting of premium payments from a prior to a current period of coverage or vice versa in the event that the enrollee indicates that they were not initially credited as he/she intended.

D. PROCEDURE--ENROLLEE DIES BEFORE NEW COVERAGE PERIOD BEGINS

If an enrollee who owes premiums for a prior period of coverage dies after reenrollment, but prior to the effective date of coverage, any premium payment is credited to his/her prior period premium obligation regardless of how he/she wished these premiums to be credited