[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: 42CFR408.50]



[Page 281]

 

                         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 C_Deduction From Monthly Benefits

 

Sec. 408.50  When premiums are considered paid.



    (a) Actual deduction. A premium is considered paid if it is actually 

deducted from a monthly benefit check. Therefore--

    (1) The premium is ``paid'' even if SSA later finds that the benefit 

was paid in error; but

    (2) A finding that a monthly benefit was erroneously withheld does 

not constitute payment of the premium for that month. Since there was no 

payment, there was no deduction. The enrollee is billed and continuance 

of coverage depends on payment of premiums before the end of the grace 

period or extended grace period.

    (b) Payment within the grace period. Overdue premiums are considered 

paid within the grace period in the following situations:

    (1) Benefits are resumed during the grace period. (i) Monthly cash 

benefit payments are payable for the last month of the initial grace 

period or for earlier months on the basis of a notice filed by the 

enrollee before the initial grace period ends; and

    (ii) Those payments are sufficient to permit deduction of all 

overdue premiums.

    (2) Annual earnings report or other report submitted during the 

grace period shows a benefit is due. (i) Before the end of the grace 

period, the enrollee submits a report clearly showing that monthly cash 

benefits, previously withheld, are payable; and

    (ii) Those benefits are sufficient to permit deduction of the full 

amount of the overdue premiums.

    (3) Premium arrears are paid by direct remittance. The enrollee 

makes a direct remittance payment of all overdue premiums before the end 

of the grace period.



[52 FR 48115, Dec. 18, 1987; 53 FR 4159, Feb. 12, 1988; 56 FR 48112, 

Sept. 24, 1991]