[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR406.20]



[Page 255]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 406_HOSPITAL INSURANCE ELIGIBILITY AND ENTITLEMENT--Table of Contents

 

                  Subpart C_Premium Hospital Insurance

 

Sec. 406.20  Basic requirements.





    (a) General provisions. Hospital insurance benefits are available to 

most individuals age 65 or over and to certain individuals under age 65 

who do not qualify for those benefits under subpart B of this part and 

are willing to pay a monthly premium. This is called premium hospital 

insurance.

    (b) Eligibility of individuals age 65 or over to enroll for premium 

hospital insurance. Any individual is eligible to enroll for Medicare 

Part A if he or she--

    (1) Has attained age 65;

    (2) Is a resident of the United States and is either--

    (i) A citizen of the United States; or

    (ii) An alien lawfully admitted for permanent residence who has 

resided in the United States continuously for the 5-year period 

immediately preceding the month in which he or she meets all other 

requirements;

    (3) Is not eligible for Part A benefits under subpart B of this 

part; and

    (4) Is entitled to supplementary medical insurance (Part B of 

Medicare) or is eligible and has enrolled for it during an enrollment 

period.

    (c) Eligibility of individuals under age 65 to enroll for premium 

hospital insurance. An individual who has not attained age 65 is 

eligible to enroll for Medicare Part A if he or she meets the following 

conditions:

    (1) Has been entitled to Medicare Part A (under Sec. 406.12 or 

Sec. 406.15) on the basis of entitlement or deemed entitlement to 

social security disability benefits, as provided under section 226(b) of 

the Act.

    (2) Continues to have a disabling physical or mental impairment.

    (3) Loses entitlement to disability benefits (and therefore also 

loses entitlement to Medicare Part A under Sec. 406.12) solely because 

his or her earnings exceed the amount allowed under the social security 

regulations pertaining to ``substantial gainful activity'' (20 CFR 

404.1571-404.1574); and

    (4) Is not otherwise entitled to Medicare Part A.



[56 FR 38078, Aug. 12, 1991; 56 FR 50058, Oct. 3, 1991]