[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: 42CFR406.28]



[Page 258-259]

 

                         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. 406.28  End of entitlement.



    Any of the following actions or events ends entitlement to premium 

hospital insurance:

    (a) Filing of request for termination. The beneficiary may at any 

time give CMS or the Social Security Administration written notice that 

he or she no longer wishes to participate in the premium hospital 

insurance program.

    (1) If he or she files the notice before entitlement begins, he or 

she will be deemed not to have enrolled.

    (2) If he or she files the notice after entitlement begins, that 

entitlement will end at the close of the month following the month in 

which he or she filed the notice.

    (b) Eligibility for hospital insurance without premiums. (1) If an 

individual



[[Page 259]]



meets the eligibility requirements for hospital insurance specified in 

Sec. 406.10, Sec. 406.11, Sec. 406.13 or Sec. 406.15, entitlement to 

premium hospital insurance ends with the month before the month in which 

he or she meets those requirements.

    (2) If an individual meets the requirements of Sec. 406.10, Sec. 

406.11, Sec. 406.13, or Sec. 406.15, he or she will be deemed to have 

filed the required application for hospital insurance benefits in his or 

her first month of eligibility under that section.

    (c) End of entitlement to supplementary medical insurance (SMI) for 

individual who has attained age 65. In the case of an individual 

enrolled on the basis of Sec. 406.20(b), entitlement to premium 

hospital insurance ends on the same date that entitlement to SMI ends.

    (d) Nonpayment of premium. (1) If an individual fails to pay the 

premium bill, entitlement will end on the last day of the third month 

after the billing month.

    (2) CMS may reinstate entitlement if the individual shows good cause 

for failure to pay on time, and pays all overdue premiums within 3 

calendar months after the date specified in paragraph (d)(1) of this 

section.

    (e) Death. Entitlement ends with the day of death. (A premium is due 

for the month of death.)

    (f) End of disabling impairment for individual under age 65. In the 

case of an individual enrolled on the basis of Sec. 406.20(c), 

entitlement to premium hospital insurance ends on the last day of the 

month after the month in which the individual is notified that he or she 

no longer has a disabling impairment.



[48 FR 12536, Mar. 25, 1983. Redesignated at 51 FR 41338, Nov. 14, 1986, 

as amended at 53 FR 47204, Nov. 22, 1988. Redesignated and amended at 56 

FR 38080, Aug. 12, 1991]