(Medicare General Information, Eligibility, and Entitlement)

40.9.3 - Effective Date of Entitlement to Part B- ID (Rev. 11646; Issued:10- 19-22; Effective:01 -01-23; Implementation:01 -03-23)  The effective date of an individuals eligibility for the Part B -ID benefit depends on when their entitlement to Medicare Part A based on ESRD ends and when they submit the attestation described in section 40.9.1 of this chapter.   When an individuals Medicare Part A entitlement based on ESRD ends on or after January 1, 2023:   If they submit  the attestation before the end of the 36th month after the month of the kidney transplant (i.e. before their Medicare Part A entitlement based on ESRD ends), Part B -ID begins effective at the start of the month after their Medicare Part A on the basis of ESRD ends.     If they submit the attestation after their Medicare Part A entitlement ends, Part B -ID begins at the start of the month following the month in which the attestation is submitted.   When an individuals Medicare Part A entitlement based on ESRD  ends prior to January 1, 2023:   If they submit the attestation to enroll from October 1, 2022 through December 31, 2022, Part B -ID begins effective January 1, 2023.   If they submit the attestation to enroll after December 31, 2022, Part B -ID begins the following month.     40.9.4 - Initial Enrollment & Reenrollment in Part B -ID (Rev. 11764; Issued 12- 22-22; Implementation: 01- 01-2023; Effective 01- 03-23)  There are no enrollment periods associated with Part B -ID. Therefore, eligible individuals can enroll at any time without regard t o Medicare enrollment periods. The earliest date on which they may initially enroll depends on when their Medicare Part A entitlement based on ESRD ends, under the following two scenarios:   1. When an individuals Medicare Part A entitlement based on ESRD ends on or after January 1, 2023, they may enroll in Part B -ID any time after their Medicare Part A on the basis of ESRD entitlement ends.    2. When an individuals Medicare Part A entitlement based on ESRD ends prior to January 1, 2023, they may enroll in Par t B-ID beginning October 1, 2022 and their coverage will start the later of January 2023 or the month after they enroll.  Individuals who had previously enrolled in Part B -ID can reenroll at any time if they meet the eligibility requirements in section 40. 9.1.   NOTE: Late enrollment penalties are not  applicable to Part B -ID enrollment. Additional information is outlined under subsection 40.9.7 (Part B -ID Premiums).   40.9.5 - Procedure for Enrolling in Part B -ID (Rev. 11764; Issued 12- 22-22; Implementation:  01-01-2023; Effective 01- 03-23)  Eligible individuals may enroll by:  1. calling SSA at 1 -877-465-0355 and providing an oral attestation, or  2. completing and filing the Application for Enrollment in Part B -ID. Immunosuppressive Drug Coverage Form CMS -10798 and mailing it to the following address:  SOCIAL SECURITY ADMINISTRATION  OFFICE OF CENTRAL OPERATIONS  PO Box 32914 BALTIMORE, MARYLAND 21298   Note: The Office of Central Operations Office of Disability Operations teleservice center (ODO TSC) will only be handling the telephonic enrollments and PC 7 will process the enrollment for Part B -ID.   40.9.6 - Termination of Part B -ID (Rev. 11646; Issued :10-19-22; Effective:01 -01-23; Implementation:01 -03-23)  1. Individuals enrolled in other health coverage are required to notify SSA and terminate Part B -ID a. When a Part B -ID covered individual notifies SSA that they have enrolled in other coverage, and if not  otherwise specified, Part B -ID terminates effective with the first day of the month following the month SSA receives the notification.    b. If the individual states that their other health insurance begins in the future, the individual may request a termination date up to 6 months in the future.   Example: If an individual enrolls in employer health coverage during an employers open enrollment period in October, for a January 1st effective date, the individual can submit their request for termination of the Part B -ID benefit in October or November, and not lose their Part B-ID benefit prior to the January 1st effective date.   c. When a state ends buy -in for Part B -ID because an individual gained full Medicaid eligibility that includes immunosuppressive drug coverage, the individual must report this new eligibility to SSA and terminate Part B -ID coverage.   If a Part B -ID covered individual fails to notify SSA of their enrollment in other health coverage, including employer and Medicaid, Part B- ID will terminate effective the first day of the month after the month in which SSA discovers the individual has other health coverage.     2. Voluntary termination request  In general, Part B -ID terminates effective with the first day of the month following the month in which we receive the request.   There is an exception to this general rule for individuals who had state payment of their Part B-ID premium under a Medicare Savings Program (as d escribed in section 40.9.9) and who are notified by SSA that their state will no longer pay their Medicare Part B -ID premiums. For these individuals the following entitlement end dates apply:  a. If the individual files a voluntary termination request within 30 days after the date of the notice that state payment of premiums will end or has ended, the individual's Part B- ID entitlement ends on the last day of the last month for which the state paid the premium.   b. If the individual files the voluntary terminatio n request more than 30 days but not more than 6 months after state payment of Medicare Part B -ID premiums ends, Part B-ID entitlement ends on the last day of the month in which the request is filed.  c. If the individual files the voluntary termination reques t later than the 6th month after state payment of Medicare Part B- ID premiums ends, entitlement ends at the end of the month after the month in which request is filed.   We note that individuals who lose eligibility for state payment of Medicare Part B -ID premiums through a Medicare Savings Program will continue to be eligible for the Part B-ID benefit without interruption with the individual assuming responsibility for paying the Part B -ID premiums, unless they voluntarily terminate. The options for financi al relief from Part B billing in SSAs Program Operations Manual System (POMS), section HI.00815.042, also apply for the Part B -ID coverage here.   3. Death  - Entitlement to Part B -ID continues into the month of death, up to and including the date of death.   4. Non-payment of  premiums   Part B -ID coverage will terminate for non -payment of premiums following the same rules, including grace periods, used for Medicare Part B for monthly billing in sections 40.5 and 40.7.4 of this manual. Note that section 40.5 provides end of coverage information, and section 40.7.4 provides grace period payment information.     5. Individual becomes entitled to Medicare on another basis   In cases where a Part B -ID enrollee becomes eligible for Medicare based on age, disability, or ESRD , Part B -ID will terminate effective with the last day of the month prior to the month in which they become entitled on the other basis.  Equitable relief for retroactivity may apply.   40.9.7 - Part B -ID Premiums (Rev.  11764; Issued 12- 22-22; Implementation: 01- 01-2023; Effective 01- 03-23)  Part B -ID premiums may be adjusted based on rounding, the income -related monthly adjusted amounts (IRMAA), and the hold harmless provision, but will not be increased based on late enrollment.   If the indivi dual is directly billed for premiums, billing will be on a monthly basis.  40.9.8 - Procedure for Termination of Part B -ID (Rev. 11764; Issued 12- 22-22; Implementation: 01- 01-2023; Effective 01- 03-23)  Individuals enrolled in the Part B -ID benefit can repo rt other coverage and request to terminate their enrollment by either: 1. calling SSA at 1 -877-465-0355 to disenroll over the phone to verbally request termination, or  2. completing and submitting Form CMS -1763, Request for Termination of Premium Hospital and/o r Supplementary Medical Insurance, and mailing it to:   SOCIAL SECURITY ADMINISTRATION  OFFICE OF CENTRAL OPERATIONS  PO Box 32914 BALTIMORE, MARYLAND 21298   3. any other request to SSA that shows the unequivocal desire to end coverage.   Note: The Office of Central Operations Office of Disability Operations teleservice center (ODO TSC) only will handle the telephonic disenrollment and PC 7 will process the disenr ollment for Part B -ID.  When the individual is reporting other coverage and choosing a future termination date, a termination effective date that is more than 6 months in the future cannot  be processed   40.9.9 - Medicare Savings Programs for Part B -ID Premiums  (Rev. 11764; Issued 12- 22-22; Implementation: 01- 01-2023; Effective 01- 03-23)  Individuals enrolled in Part B -ID with limited income and resources may be eligible for assistance through the Medicare Savings Programs (MSPs). The MSPs include three eligibility groups that cover Part B -ID premiums and sometimes cost sharing, including:    Qualified Medicare Beneficiary (QMB)   Specified Low -Income Medicare Beneficiary (SLMB)   Qualifying Individuals (QI)   There are two ways to enroll in the MSPs for the payment of the Part B -ID premiums.  First, once enrolled in Part B -ID, individuals may apply for the MSPs and be determined eligible by their state for an MSP eligibility group based on Part B -ID.   Second, individuals who are enrolled in an MSP group and los e Medicare entitlement based on ESRD 36 months after the month in which they receive a kidney transplant can transition to an MSP based on Part B -ID enrollment without a break in coverage if: (1)they attest that they do not have other health coverage as de scribed in 40.9.1 by the end of the 36th month after the month in which they receive a kidney transplant; and (2) the state redetermines the individuals Medicaid eligibility on all bases and does not otherwise find the individual ineligible for the MSP gr oup.  50 - Identifying the Patient's Health Insurance Record Using the  Medicare Card  (Rev. 124, Issued: 05- 17-19, Effective: 06 -18-19, Implementation: 06- 18-19  As part of health insurance electronic data processing, Medicare cards are issued by CMS to individuals who have established entitlement to health insurance.   Below is an example of the Medicare card.   New Medicare Card           New Medicare Card  Front             New Medicare Card Back                                 The Medicare card is used to identify the individual as being entitled and also serves as a source of info rmation required to process Medicare claims or bills. It displays the beneficiary's name, Medicare number, and effective date of entitlement to hospital insurance and/or medical insurance. The Social Security Administration's Social Security Office assists  in replacing a lost or destroyed Medicare cards.   50.1 - Medicare Beneficiary Identifier (M BI) (Rev.  12046, Issued:05- 18-23, Effective:01-01-23, Implementation:06-21-23)  The term Medicare beneficiary identifier (M BI) is a general term describing a beneficiarys Medicare identification number. For purposes of this manual, Medicare beneficiary identifier references both the Health Insurance Claim Number (HICN) and the Medicare Beneficiary Identifier (MBI) during the new Medicare card tran sition period and after for certain business areas that will continue to use the HICN as part of their processes.