Generally; regulations
An individual may enroll in the insurance program established by this part only in such manner and form as may be prescribed by regulations, and only during an enrollment period prescribed in or under this section.
Pub. L. 96–499, title IX, § 945(a)94 Stat. 2642 Repealed. , ,
Initial general enrollment period; eligible individuals before
ooIn the case of individuals who first satisfy paragraph (1) or (2) of section 1395(a) of this title before , the initial general enrollment period shall begin on the first day of the second month which begins after , and shall end on . For purposes of this subsection and subsection (d), an individual who has attained age 65 and who satisfies paragraph (1) of section 1395(a) of this title but not paragraph (2) of such section shall be treated as satisfying such paragraph (1) on the first day on which he is (or on filing application would have been) entitled to hospital insurance benefits under part A.
Eligible individuals on or after
osection 1395q of this titleIn the case of an individual who first satisfies paragraph (1) or (2) of section 1395(a) of this title on or after , his initial enrollment period shall begin on the first day of the third month before the month in which he first satisfies such paragraphs and shall end seven months later. Where the Secretary finds that an individual who has attained age 65 failed to enroll under this part during his initial enrollment period (based on a determination by the Secretary of the month in which such individual attained age 65), because such individual (relying on documentary evidence) was mistaken as to his correct date of birth, the Secretary shall establish for such individual an initial enrollment period based on his attaining age 65 at the time shown in such documentary evidence (with a coverage period determined under as though he had attained such age at that time).
General enrollment period
There shall be a general enrollment period during the period beginning on January 1 and ending on March 31 of each year.
Individuals deemed enrolled in medical insurance program
Commencement of enrollment period
Waiver of enrollment period requirements where individual’s rights were prejudiced by administrative error or inaction
section 1395i–2 of this titleIn any case where the Secretary finds that an individual’s enrollment or nonenrollment in the insurance program established by this part or part A pursuant to is unintentional, inadvertent, or erroneous and is the result of the error, misrepresentation, or inaction of an officer, employee, or agent of the Federal Government, or its instrumentalities, the Secretary may take such action (including the designation for such individual of a special initial or subsequent enrollment period, with a coverage period determined on the basis thereof and with appropriate adjustments of premiums) as may be necessary to correct or eliminate the effects of such error, misrepresentation, or inaction.
Special enrollment periods
Special rules for individuals with ALS
Special enrollment period for certain volunteers serving outside United States
Special enrollment period for disabled TRICARE beneficiaries
Special enrollment periods for exceptional circumstances
oBeginning , the Secretary may establish special enrollment periods in the case of individuals who satisfy paragraph (1) or (2) of section 1395(a) of this title and meet such exceptional conditions as the Secretary may provide.
Enrollment for individuals only eligible for coverage of immunosuppressive drugs
Special enrollment period for certain Postal Service annuitants and family members
Aug. 14, 1935, ch. 531 Pub. L. 89–97, title I, § 102(a)79 Stat. 304 Pub. L. 89–384, § 3(a)80 Stat. 105 Pub. L. 90–248, title I81 Stat. 853 Pub. L. 92–603, title II86 Stat. 1372 Pub. L. 96–265, title I, § 103(a)(3)94 Stat. 444 Pub. L. 96–499, title IX, § 945(a)94 Stat. 2642 Pub. L. 97–35, title XXI, § 2151(a)(1)95 Stat. 801 Pub. L. 98–369, div. B, title III98 Stat. 1092 Pub. L. 99–272, title IX100 Stat. 171 Pub. L. 99–509, title IX, § 9319(c)(1)100 Stat. 2011 Pub. L. 99–514, title XVIII, § 1895(b)(12)100 Stat. 2934 Pub. L. 101–239, title VI, § 6202(b)(4)(C)103 Stat. 2233 Pub. L. 103–432, title I108 Stat. 4430 Pub. L. 105–33, title IV111 Stat. 465 Pub. L. 106–554, § 1(a)(6) [title I, § 115(b)]114 Stat. 2763 Pub. L. 109–171, title V, § 5115(a)(2)(A)120 Stat. 45 Pub. L. 111–148, title III, § 3110(a)(1)124 Stat. 420 Pub. L. 116–260, div. CC, title I, § 120(a)(2)(A)134 Stat. 2954 Pub. L. 117–108, title I, § 101(b)(1)136 Stat. 1136 (, title XVIII, § 1837, as added , , ; amended , (b), , ; , §§ 136(a), 145(a), (b), , , 859; , §§ 201(c)(2), 206(a), 259(a), 260, , , 1378, 1448; , , ; , (b), , ; , (2), , ; , §§ 2338(b), 2354(b)(10), , , 1101; , §§ 9201(c)(1), 9219(a)(2), , , 182; –(3), , ; , , ; , (c)(1), , ; , §§ 147(f)(1)(A), 151(c)(2), , , 4435; , §§ 4581(b)(1), 4631(a)(2), , , 486; , , , 2763A–474; , , ; , , ; , title IV, § 402(a)(2)(B), (b), , , 2999; , , .)
Editorial Notes
References in Text
section 501 of Title 26Section 501 of the Internal Revenue Code of 1986, referred to in subsec. (k)(3)(A)(ii), is classified to , Internal Revenue Code.
Amendments
oPub. L. 117–108o2022—Subsec. (). added subsec. ().
Pub. L. 116–260, § 402(a)(2)(B)(i)oo2020—, substituted “section 1395(a) of this title” for “section 1395 of this title” wherever appearing except in subsec. (m).
Pub. L. 116–260, § 402(a)(2)(B)(ii)ooSubsec. (j)(1). , substituted “section 1395(a)(1) of this title” for “section 1395(1) of this title”.
Pub. L. 116–260, § 120(a)(2)(A)Subsec. (m). , added subsec. (m).
Pub. L. 116–260, § 402(b)Subsec. (n). , added subsec. (n).
lPub. L. 111–148l2010—Subsec. (). added subsec. ().
Pub. L. 109–1712006—Subsec. (k). added subsec. (k).
Pub. L. 106–5542000—Subsec. (j). added subsec. (j).
Pub. L. 105–33, § 4631(a)(2)1997—Subsec. (i)(1) to (3). , substituted “1395y(b)(1)(B)(iii) of this title” for “1395y(b)(1)(B)(iv) of this title” wherever appearing.
Pub. L. 105–33, § 4581(b)(1)Subsec. (i)(4). , added par. (4).
Pub. L. 103–432, § 151(c)(2)(A)section 1395y(b)(1)(B)(iv) of this titlesection 1395y(b)(1)(B)(iv) of this title1994—Subsec. (i)(1). , in closing provisions substituted “(as that term is defined in ) by reason of the individual’s current employment status (or the current employment status of a family member of the individual)” for “as an active individual (as those terms are defined in )”.
Pub. L. 103–432, § 151(c)(2)(D)Subsec. (i)(1)(A). , inserted “status” after “current employment”.
Pub. L. 103–432, § 151(c)(2)(A)section 1395y(b)(1)(B)(iv) of this titlesection 1395y(b)(1)(B)(iv) of this titleSubsec. (i)(2). , (C), in closing provisions substituted “(as that term is defined in ) by reason of the individual’s current employment status (or the current employment status of a family member of the individual)” for “as an active individual (as those terms are defined in )” and “by reason of the individual’s current employment status (or the current employment status of a family member of the individual)” for “as an active individual”.
Pub. L. 103–432, § 151(c)(2)(D)Subsec. (i)(2)(B), (C). , inserted “status” after “current employment”.
Pub. L. 103–432, § 151(c)(2)(D)Subsec. (i)(3)(A). , inserted “status” after “current employment”.
Pub. L. 103–432, § 147(f)(1)(A), substituted “including each month during any part of which the individual is enrolled” for “beginning with the first day of the first month in which the individual is no longer enrolled” and “ending with the last day of the eighth consecutive month in which the individual is at no time so enrolled” for “and ending seven months later”.
Pub. L. 103–432, § 151(c)(2)(B)section 1395y(b)(1)(B)(iv) of this titlesection 1395y(b)(1)(B)(iv) of this titleSubsec. (i)(3)(B). , substituted “in a large group health plan (as that term is defined in ) by reason of the individual’s current employment status (or the current employment status of a family member of the individual)” for “as an active individual in a large group health plan (as such terms are defined in )”.
Pub. L. 103–432, § 147(f)(1)(A), substituted “including each month during any part of which the individual is enrolled” for “beginning with the first day of the first month in which the individual is no longer enrolled” and “ending with the last day of the eighth consecutive month in which the individual is at no time so enrolled” for “and ending seven months later”.
Pub. L. 101–239, § 6202(c)(1)(A)1989—Subsec. (i)(1). , redesignated subpars. (B) and (C) as (A) and (B), respectively, struck out former subpar. (A) which read as follows: “has attained the age of 65,”, and inserted “not described in the previous sentence” after “In the case of an individual” in second sentence.
Pub. L. 101–239, § 6202(b)(4)(C), substituted “section 1395y(b)(1)(A)(v)” and “section 1395y(b)(1)(B)(iv)” for “section 1395y(b)(3)(A)(iv)” and “section 1395y(b)(4)(B)”, respectively.
Pub. L. 101–239, § 6202(c)(1)(B)Subsec. (i)(2). , substituted “(1)(A)” for “(1)(B)” in subpar. (B)(i), redesignated subpars. (B) and (C) as (A) and (B), respectively, struck out former subpar. (A) which read as follows: “has attained the age of 65;”, and inserted “not described in the previous sentence” after “In the case of an individual” in second sentence.
Pub. L. 101–239, § 6202(b)(4)(C), substituted “section 1395y(b)(1)(A)(v)” and “section 1395y(b)(1)(B)(iv)” for “section 1395y(b)(3)(A)(iv)” and “section 1395y(b)(4)(B)”, respectively.
Pub. L. 101–239, § 6202(b)(4)(C)Subsec. (i)(3). , substituted “section 1395y(b)(1)(A)(v)” and “section 1395y(b)(1)(B)(iv)” for “section 1395y(b)(3)(A)(iv)” and “section 1395y(b)(4)(B)”, respectively.
Pub. L. 99–509, § 9319(c)(1)1986—Subsec. (i)(1). , inserted sentence at end providing for a special enrollment period described in paragraph (3)(B) for individuals not age 65, enrolled in a large health plan, and having elected not to enroll during initial enrollment period.
Pub. L. 99–514Subsec. (i)(1)(A). realigned margins of subpar. (A).
Pub. L. 99–272, § 9219(a)(2)(A)section 1395y(b)(3)(A) of this title, amended subpar. (A) generally, substituting “has attained the age of 65” for “meets the conditions described in clauses (i) and (iii) of ”.
Pub. L. 99–509, § 9319(c)(2)Subsec. (i)(2). , inserted sentence at end providing for a special enrollment period described in paragraph (3)(B) for individuals not age 65, enrolled or deemed enrolled in the medical insurance program established under this part, or is an individual described in the second sentence of paragraph (1), has enrolled in such program during a subsequent special enrollment period during which the individual was not enrolled in a large group health plan, and has not terminated enrollment.
Pub. L. 99–272, § 9219(a)(2)(B)section 1395y(b)(3)(A) of this titleSubsec. (i)(2)(A). , amended subpar. (A) generally, substituting “has attained the age of 65;” for “meets the conditions described in clauses (i) and (iii) of ,”.
Pub. L. 99–272, § 9219(a)(2)(B)section 1395y(b)(3)(A)(iv) of this titleSubsec. (i)(2)(B). , amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “has enrolled (or has been deemed to have enrolled) in the medical insurance program established under this part during the individual’s initial enrollment period and any subsequent special enrollment period under this subsection during which the individual was not enrolled in a group health plan described in by reason of the individual’s (or individual’s spouse’s) current employment, and”.
Pub. L. 99–272, § 9219(a)(2)(B)Subsec. (i)(2)(C), (D). , added subpar. (C) and redesignated former subpar. (C) as (D).
Pub. L. 99–509, § 9319(c)(3)Subsec. (i)(3). , designated existing provisions as subpar. (A), inserted “the first sentences of” after “referred to in”, and added subpar. (B).
Pub. L. 99–272, § 9201(c)(1), amended par. (3) generally, striking out provision that special enrollment period could be period beginning with first day of third month before month in which the individual attains age of 70 and ending seven months later.
Pub. L. 98–369, § 2354(b)(10)section 426(b) of this titlesection 426(a)(2)(B) of this titlesection 1395r(d) of this titlesection 1395(e) of this title1984—Subsec. (g)(1). , substituted “” for “” and “” for “”.
Pub. L. 98–369, § 2338(b)Subsec. (i). , added subsec. (i).
Pub. L. 97–35, § 2151(a)(1)1981—Subsec. (e). , substituted “during the period beginning on January 1 and ending on March 31 of each year” for “which is any period after the period described in subsection (d) of this section”.
Pub. L. 97–35, § 2151(a)(2)Subsec. (g)(3). , substituted “the earlier of the then current or immediately succeeding general enrollment period (as defined in subsection (e) of this section)” for “the month in which the individual files an application establishing such entitlement”.
Pub. L. 96–499, § 945(a)1980—Subsec. (b). , struck out subsec. (b) which provided that no individual could enroll under this part more than twice.
Pub. L. 96–499, § 945(b)(1)Subsec. (e). , substituted “which is any period after the period described in subsection (d) of this section” for “, after the period described in subsection (c) of this section, during the period beginning on January 1 and ending on March 31 of each year beginning with 1969”.
Pub. L. 96–265Subsec. (g)(1). substituted “the 25th month” for “the 25th consecutive month”.
Pub. L. 96–499, § 945(b)(2)Subsec. (g)(3). , substituted “the month in which the individual files an application establishing such entitlement” for “the earlier of the then current or immediately succeeding general enrollment period (as defined in subsection (e) of this section)”.
Pub. L. 92–603, § 2601972—Subsec. (b). , struck out provisions preventing enrollment under this part more than three years after first opportunity for such enrollment.
Pub. L. 92–603, § 201(c)(2)(A)ooSubsec. (c). , (B), substituted “paragraph (1) or (2)” for “paragraphs (1) and (2)”, and substituted provisions relating to the treatment of an individual who has attained age 65 and who satisfies paragraph (1) of section 1395 of this title but not paragraph (2) of such section, for provisions relating to the treatment of an individual who satisfies paragraph (2) of section 1395 of this title solely by reason of subparagraph (B) thereof.
Pub. L. 92–603, § 201(c)(2)(C)Subsec. (d). , substituted “paragraph (1) or (2)” for “paragraphs (1) and (2)”.
Pub. L. 92–603, § 206(a)Subsecs. (f), (g). , added subsecs. (f) and (g).
Pub. L. 92–603, § 259(a)Subsec. (h). , added subsec. (h).
Pub. L. 90–248, § 145(a)1968—Subsec. (b)(1). , permitted an individual enrolling in supplementary medical insurance program for first time to enroll at any time in a general enrollment period which begins within 3 years of close of his initial enrollment period.
Pub. L. 90–248, § 136(a)Subsec. (d). , inserted last sentence providing that if an individual who has attained age 65 failed to enroll in program because, relying on erroneous documentary evidence, he was mistaken about his age, he may enroll using date of attainment of age 65 that he alleges under documentary evidence.
Pub. L. 90–248, § 145(b)Subsec. (e). , provided for an annual general enrollment period for supplementary medical insurance program beginning January 1 and ending March 31 of each year, commencing in 1969.
Pub. L. 89–384, § 3(a)1966—Subsec. (c). , delayed eligibility date from , to , and closing date for enrollment period from , to .
Pub. L. 89–384, § 3(b)Subsec. (d). , substituted , for .
Statutory Notes and Related Subsidiaries
Effective Date of 2010 Amendment
Pub. L. 111–148, title III, § 3110(a)(2)124 Stat. 420 Pub. L. 111–309, title II, § 201124 Stat. 3289
Pub. L. 111–309, title II, § 201124 Stat. 3289 section 3110(a)(2) of Pub. L. 111–148Pub. L. 111–148[, , , provided that the amendment made by section 201 to , set out above, is effective as if included in the enactment of .]
Effective Date of 2006 Amendment
Pub. L. 109–171, title V, § 5115(b)120 Stat. 46
Effective Date of 2000 Amendment
Pub. L. 106–554Pub. L. 106–554section 426 of this titleAmendment by applicable to benefits for months beginning , see section 1(a)(6) [title I, § 115(c)] of , set out as a note under .
Effective Date of 1997 Amendment
Pub. L. 105–33, title IV, § 4581(c)111 Stat. 465
Effective Date of 1994 Amendment
Pub. L. 103–432, title I, § 147(f)(1)(C)108 Stat. 4431
Pub. L. 103–432, title I, § 151(c)(2)108 Stat. 4435 Pub. L. 103–66, , , provided that the amendment made by that section is effective as if included in the enactment of .
Effective Date of 1989 Amendment
section 6202(b)(4)(C) of Pub. L. 101–239section 6202(b)(5) of Pub. L. 101–239section 162 of Title 26Amendment by applicable to items and services furnished after , see , set out as a note under , Internal Revenue Code.
Pub. L. 101–239, title VI, § 6202(c)(3)103 Stat. 2234
Effective Date of 1986 Amendment
Pub. L. 99–514Pub. L. 99–272section 1895(e) of Pub. L. 99–514section 162 of Title 26Amendment by effective, except as otherwise provided, as if included in enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, , see , set out as a note under , Internal Revenue Code.
Pub. L. 99–509section 9319(f)(2) of Pub. L. 99–509section 1395y of this titleAmendment by applicable to enrollments occurring on or after , see , set out as a note under .
Pub. L. 99–272, title IX, § 9201(d)(2)100 Stat. 171
Pub. L. 99–272, title IX, § 9219(a)(3)(B)100 Stat. 182
Effective Date of 1984 Amendment
Pub. L. 98–369, div. B, title III, § 2338(d)(2)98 Stat. 1093
section 2354(b)(10) of Pub. L. 98–369section 2354(e)(1) of Pub. L. 98–369section 1320a–1 of this titleAmendment by effective , but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see , set out as a note under .
Effective Date of 1981 Amendment
Pub. L. 97–35, title XXI, § 2151(b)95 Stat. 802
Effective Date of 1980 Amendment
Pub. L. 96–499, title IX, § 945(d)94 Stat. 2642
Pub. L. 96–265section 103(c) of Pub. L. 96–265section 426 of this titleAmendment by applicable with respect to hospital insurance or supplementary medical insurance benefits for services provided on or after the first day of the sixth month which begins after , see , set out as a note under .
Effective Date of 1972 Amendment
Pub. L. 92–603, title II, § 259(b)86 Stat. 1448
Effective Date of 1968 Amendment
Pub. L. 90–248, title I, § 136(b)81 Stat. 853
Pub. L. 90–248, title I, § 145(e)81 Stat. 859
Medicare Part B Special Enrollment Period
Pub. L. 108–173, title VI, § 625(b)117 Stat. 2318
In general .—
Coverage period .—
Extension Through of 1967 General Enrollment Period
Pub. L. 90–97, § 181 Stat. 249 42 U.S.C. 1395jsection 1395q(b)(1) of this title, , , extended the general enrollment period under subsec. (e) of this section, beginning , and ending , for purposes of enrolling in the insurance program established under part B of title XVIII of such Act [ et seq.] and of terminating such enrollment as provided in , through .
Enrollment Before , of Eligible Individuals Failing for Good Cause To Enroll Before ; Commencement of Coverage Period
Pub. L. 89–97, title I, § 102(b)79 Stat. 332 Pub. L. 89–384, § 3(c)80 Stat. 105