[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: 42CFR408.24]



[Page 278-279]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 408_PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE--Table of Contents

 

                  Subpart B_Amount of Monthly Premiums

 

Sec. 408.24  Individuals who enrolled or reenrolled before April 1, 1981 

or after September 30, 1981.



    (a) Enrollment. For an individual who first enrolled before April 1, 

1981 or after September 30, 1981, the period includes the number of 

months elapsed between the close of the individual's initial enrollment 

period and the close of the enrollment period in which he or she first 

enrolled, and excludes the following:

    (1) The three months of January through March 1968, if the 

individual first enrolled before April 1968.

    (2) Any months before January 1973 during which the individual was 

precluded from enrolling or reenrolling by the 3-year limitation on 

enrollment or reenrollment that was in effect before October 30, 1972.

    (3) Any months in or before a period of coverage under a State buy-

in agreement.

    (4) For an individual under age 65, any month before his or her 

current continuous period of entitlement to hospital insurance.

    (5) For an individual age 65 or older, any month before the month he 

or she attained age 65.

    (6) For premiums due for months beginning with September 1984 and 

ending with May 1986, the following:

    (i) Any months after December 1982 during which the individual was--

    (A) Age 65 to 69;

    (B) Entitled to hospital insurance (Medicare Part A); and

    (C) Covered under a group health plan (GHP) by reason of current 

employment status.

    (ii) Any months of SMI coverage for which the individual enrolled 

during a special enrollment period as provided in Sec. 407.20 of this 

chapter.

    (7) For premiums due for months beginning with June 1986, the 

following:

    (i) Any months after December 1982 during which the individual was:

    (A) Age 65 or over; and

    (B) Covered under a GHP by reason of current employment status.

    (ii) Any months of SMI coverage for which the individual enrolled 

during a special enrollment period as provided in Sec. 407.20 of this 

chapter.

    (8) For premiums due for months beginning with January 1987, the 

following:

    (i) Any months after December 1986 and before October 1998 during 

which the individual was:

    (A) A disabled Medicare beneficiary under age 65;

    (B) Not eligible for Medicare on the basis of end stage renal 

disease, under Sec. 406.13 of this chapter; and

    (C) Covered under an LGHP as described in Sec. 407.20 of this 

chapter.

    (ii) Any months of SMI coverage for which the individual enrolled 

during a special enrollment period as provided in Sec. 407.20 of this 

chapter.

    (9) For premiums due for months beginning with July 1990, the 

following:

    (i) Any months after December 1986 during which the individual met 

the conditions of paragraphs (a)(8)(i)(A) and (a)(8)(i)(B) of this 

section, and was covered under a GHP by reason of the current employment 

status of the individual or the individual's spouse.

    (ii) Any months of SMI coverage for which the individual enrolled 

during a special enrollment period as provided in Sec. 407.20 of this 

chapter.

    (b) Reenrollment. For an individual who reenrolled before April 1, 

1981 or after September 30, 1981, the period:

    (1) Includes the following:

    (i) The number of months elapsed between the close of the 

individual's initial enrollment period and the close of the enrollment 

period in which he or she first enrolled; plus

    (ii) The number of months elapsed between the individual's initial 

period of coverage and the close of the enrollment period in which he or 

she reenrolled; plus



[[Page 279]]



    (iii) The number of months elapsed between each subsequent period of 

coverage and the close of the enrollment period in which he or she 

reenrolled.

    (2) Excludes the following:

    (i) The periods specified in paragraphs (a)(1) through (a)(9) of 

this section; and

    (ii) Any month before April 1981 during which the individual was 

precluded from reenrolling by the two-enrollment limitation in effect 

before that date.



[52 FR 48118, Dec. 18, 1987, as amended at 53 FR 6648, Mar. 2, 1988; 61 

FR 40347, Aug. 2, 1996]