[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: 42CFR407.18]



[Page 265]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 407_SUPPLEMENTARY MEDICAL INSURANCE (SMI) ENROLLMENT AND ENTITLEMENT

--Table of Contents

 

         Subpart B_Individual Enrollment and Entitlement for SMI

 

Sec. 407.18  Determining month of automatic enrollment.



    (a) An individual who is automatically enrolled in SMI under Sec. 

407.17 will have the month of enrollment determined in accordance with 

paragraphs (b) through (f) of this section. The month of enrollment 

determines the month of entitlement.

    (b) An individual is automatically enrolled in the third month of 

the initial enrollment period if he or she--

    (1) Is entitled to social security benefits under section 202 of the 

Act on the first day of the initial enrollment period;

    (2) Is entitled to hospital insurance based on end-stage renal 

disease; on entitlement to disability benefits as a social security or 

railroad retirement beneficiary; or on deemed entitlement to disability 

benefits on the basis of Medicare-qualified government employment; or

    (3) Establishes entitlement to hospital insurance by filing an 

application and meeting all other requirements (as set forth in subpart 

B of part 406 of this chapter) during the first 3 months of the initial 

enrollment period.

    (c) If an individual establishes entitlement to hospital insurance 

on the basis of an application filed in the last 4 months of the SMI 

initial enrollment period, he or she is automatically enrolled for SMI 

in the month in which the application is filed.

    (d) If an individual establishes entitlement to hospital insurance 

on the basis of an application filed after the SMI initial enrollment 

period but not during a general enrollment period in effect before April 

1, 1981, or after September 30, 1981, he or she is automatically 

enrolled for SMI on the first day of the next general enrollment period.

    (e) If the individual establishes entitlement to hospital insurance 

on the basis of an application filed during a SMI general enrollment 

period in effect before April 1, 1981 or after September 30, 1981, he or 

she is automatically enrolled on the first day of that period.

    (f) If an individual established entitlement to hospital insurance 

on the basis of an application filed during the general enrollment 

period of April 1, 1981, through September 30, 1981, he or she was 

automatically enrolled for SMI on the first day of the month in which 

the application was filed.