POMS Reference

HI 03010: Applications

BASIC (04-05)

Citations:

20 CFR 418.3220

A. Policy

An Extra Help application is filed on the earliest of the:

  • protective filing date (see HI 03010.020 for protective filing date policy);

  • date it is physically received by SSA or, if mailed, 5 days before the receipt date if that date will result in another month of subsidy eligibility;

  • date it is filed at the Medicaid State Agency; or

  • date a partial i1020 is electronically submitted from SSA’s website to its database.

B. Procedure

1. Review SSA Records

Always review SSA’s records, e.g., 800 Number System, etc., to determine the earliest possible filing date for the subsidy application. If a protective filing does not exist, use the earliest of the other dates in HI 03010.015A.

2. Wilkes-Barre Data Operations (WBDOC) Procedure

The WBDOC will determine the filing date for an SSA-1020-OCR as follows:

If the SSA-1020-OCR is: WBDOC will set the filing date as:

Mailed to the WBDOC by the claimant or personal representative

5 days before the WBDOC receives the form

Mailed to the WBDOC by a State Medicaid agency

The date entered by the State in the “Official Use” block

Mailed to the WBDOC by a FO and an “H” is entered in the “Official Use” block per HI 03010.038B.1

The date entered by the FO in the “Official Use” block

Mailed to the WBDOC by a FO and an “H” is not entered in the “Official Use” block

5 days before the date entered by the FO in the “Official Use” block

Date is illegible

5 days before the WBDOC receives the form

3. Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)

The Medicare Improvements for Patients and Providers Act of 2008 becomes effective January 1, 2010. MIPPA changes include the elimination of in-kind support and maintenance as income and the cash surrender value of life insurance as a resource for Extra Help purposes. Under MIPPA, a claimant’s identity and financial information used in the Extra Help determination is transmitted to their state Medicaid agency to initiate a Medicare Savings Programs application unless the claimant objects.

In some cases, the claimant should file an Extra Help application effective January 2010 to take advantage of the statutory changes.