US Code

Public Law 119-73 (01/23/2026)

42 U.S.C. § 1395s

Payment of premiums

(a)

Deductions from section 402 or 423 monthly benefits

(1)
In the case of an individual who is entitled to monthly benefits under section 402 or 423 of this title, his monthly premiums under this part shall (except as provided in subsections (b)(1) and (c)) be collected by deducting the amount thereof from the amount of such monthly benefits. Such deduction shall be made in such manner and at such times as the Commissioner of Social Security shall by regulation prescribe. Such regulations shall be prescribed after consultation with the Secretary.
(2)
The Secretary of the Treasury shall, from time to time, transfer from the Federal Old-Age and Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph (1) for the period to which such transfer relates from benefits under section 402 or 423 of this title which are payable from such Trust Fund. Such transfer shall be made on the basis of a certification by the Commissioner of Social Security and shall be appropriately adjusted to the extent that prior transfers were too great or too small.
(b)

Deductions from railroad retirement annuities or pensions

(1)
45 U.S.C. 231section 402 of this title In the case of an individual who is entitled to receive for a month an annuity under the Railroad Retirement Act of 1974 [ et seq.] (whether or not such individual is also entitled for such month to a monthly insurance benefit under ), his monthly premiums under this part shall (except as provided in subsection (c)) be collected by deducting the amount thereof from such annuity or pension. Such deduction shall be made in such manner and at such times as the Secretary shall by regulations prescribe. Such regulations shall be prescribed only after consultation with the Railroad Retirement Board.
(2)
The Secretary of the Treasury shall, from time to time, transfer from the Railroad Retirement Account to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph (1) for the period to which such transfer relates. Such transfers shall be made on the basis of a certification by the Railroad Retirement Board and shall be appropriately adjusted to the extent that prior transfers were too great or too small.
(c)

Portion of monthly premium in excess of deducted amount

If an individual to whom subsection (a) or (b) applies estimates that the amount which will be available for deduction under such subsection for any premium payment period will be less than the amount of the monthly premiums for such period, he may (under regulations) pay to the Secretary such portion of the monthly premiums for such period as he desires.

(d)

Deductions from civil service retirement annuities

(1)
In the case of an individual receiving an annuity under subchapter III of chapter 83 of title 5 or any other law administered by the Director of the Office of Personnel Management providing retirement or survivorship protection, to whom neither subsection (a) nor subsection (b) applies, his monthly premiums under this part (and the monthly premiums of the spouse of such individual under this part if neither subsection (a) nor subsection (b) applies to such spouse and if such individual agrees) shall, upon notice from the Secretary of Health and Human Services to the Director of the Office of Personnel Management, be collected by deducting the amount thereof from each installment of such annuity. Such deduction shall be made in such manner and at such times as the Director of the Office of Personnel Management may determine. The Director of the Office of Personnel Management shall furnish such information as the Secretary of Health and Human Services may reasonably request in order to carry out his functions under this part with respect to individuals to whom this subsection applies. A plan described in section 8903 or 8903a of title 5 may reimburse each annuitant enrolled in such plan an amount equal to the premiums paid by him under this part if such reimbursement is paid entirely from funds of such plan which are derived from sources other than the contributions described in section 8906 of such title.
(2)
The Secretary of the Treasury shall, from time to time, but not less often than quarterly, transfer from the Civil Service Retirement and Disability Fund, or the account (if any) applicable in the case of such other law administered by the Director of the Office of Personnel Management, to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph (1) for the period to which such transfer relates. Such transfer shall be made on the basis of a certification by the Director of the Office of Personnel Management and shall be appropriately adjusted to the extent that prior transfers were too great or too small.
(e)

Manner and time of payment prescribed by Secretary

In the case of an individual who participates in the insurance program established by this part but with respect to whom none of the preceding provisions of this section applies, or with respect to whom subsection (c) applies, the premiums shall be paid to the Secretary at such times, and in such manner, as the Secretary shall by regulations prescribe.

(f)

Deposit of amounts in Treasury

Amounts paid to the Secretary under subsection (c) or (e) shall be deposited in the Treasury to the credit of the Federal Supplementary Medical Insurance Trust Fund.

(g)

Premium payability period

In the case of an individual who participates in the insurance program established by this part, premiums shall be payable for the period commencing with the first month of his coverage period and ending with the month in which he dies or, if earlier, in which his coverage under such program terminates.

(h)

Exempted monthly benefits

section 1395v of this titlesection 1395v(d) of this titleIn the case of an individual who is enrolled under the program established by this part as a member of a coverage group to which an agreement with a State entered into pursuant to is applicable, subsections (a), (b), (c), and (d) of this section shall not apply to his monthly premium for any month in his coverage period which is determined under .

(i)

Adjustments for individuals enrolled in Medicare+Choice plans

section 1395w–24(f)(1)(E) of this title1

1 See References in Text note below.
section 1396d(p)(3)(A)(ii) of this titleIn the case of an individual enrolled in a Medicare+Choice plan, the Secretary shall provide for necessary adjustments of the monthly beneficiary premium to reflect 80 percent of any reduction elected under and to reflect any credit provided under section 1395w–24(b)(1)(C)(iv)  of this title. To the extent to which the Secretary determines that such an adjustment is appropriate, with the concurrence of any agency responsible for the administration of such benefits, such premium adjustment may be provided directly, as an adjustment to any social security, railroad retirement, or civil service retirement benefits, or, in the case of an individual who receives medical assistance under subchapter XIX for medicare costs described in , as an adjustment to the amount otherwise owed by the State for such medical assistance.

Aug. 14, 1935, ch. 531Pub. L. 89–97, title I, § 102(a)79 Stat. 306Pub. L. 89–384, § 4(c)80 Stat. 106Pub. L. 90–248, title I, § 16681 Stat. 874Pub. L. 92–603, title II86 Stat. 1373Pub. L. 93–445, title III, § 30688 Stat. 1358Pub. L. 98–369, div. B, title III, § 2354(b)(11)98 Stat. 1101Pub. L. 99–53, § 2(g)99 Stat. 94Pub. L. 100–360, title II, § 212(b)(1)102 Stat. 740Pub. L. 100–485, title VI, § 608(d)(10)(B)102 Stat. 2415Pub. L. 101–234, title II, § 202(a)103 Stat. 1981Pub. L. 103–296, title I, § 108(c)(2)108 Stat. 1485Pub. L. 106–554, § 1(a)(6) [title VI, § 606(a)(2)(B)(ii)]114 Stat. 2763Pub. L. 108–173, title II, § 222l117 Stat. 2206(, title XVIII, § 1840, as added , , ; amended , , ; , title IV, § 403(g), , , 932; , §§ 201(c)(6), 263(a)–(d)(3), , , 1448, 1449; , , ; , title VI, § 2663(j)(2)(F)(ii), , , 1170; , , ; , , ; , , ; , , ; , , ; , , , 2763A–557; ()(2)(B), , .)

Editorial Notes

References in Text

act Aug. 29, 1935, ch. 812Pub. L. 93–445, title I, § 10188 Stat. 1305section 231 of Title 45section 231t of Title 45The Railroad Retirement Act of 1974, referred to in subsec. (b)(1), is , as amended generally by , , , which is classified generally to subchapter IV (§ 231 et seq.) of chapter 9 of Title 45, Railroads. For further details and complete classification of this Act to the Code, see Codification note set out preceding , , and Tables.

Section 1395w–24(b)(1)(C)(iv) of this titlesection 1395w–24(b)(1)(C)(v) of this titlePub. L. 111–148, title III, § 3202(b)(1)(B)124 Stat. 454section 1395w–24(b)(1)(C)(viii) of this titlePub. L. 111–152, title I, § 1102(d)(2)124 Stat. 1045, referred to in subsec. (i), was redesignated by , , , and subsequently redesignated by , , .

Amendments

Pub. L. 108–173section 1395w–24(b)(1)(C)(iv) of this titlesection 1395w–24(f)(1)(E) of this title2003—Subsec. (i). inserted “and to reflect any credit provided under ” after “” in first sentence.

Pub. L. 106–5542000—Subsec. (i). added subsec. (i).

Pub. L. 103–296, § 108(c)(2)(A)1994—Subsec. (a)(1). , substituted “Commissioner of Social Security” for “Secretary” and inserted at end “Such regulations shall be prescribed after consultation with the Secretary.”

Pub. L. 103–296, § 108(c)(2)(B)Subsec. (a)(2). , substituted “Commissioner of Social Security” for “Secretary of Health and Human Services”.

Pub. L. 101–234Pub. L. 100–360, § 212(b)(1)1989—Subsec. (i). repealed , and provided that the provisions of law amended or repealed by such section are restored or revised as if such section had not been enacted, see 1988 Amendment note below.

Pub. L. 100–4851988—Subsec. (i). substituted “Supplementary” for “Supplemental”.

Pub. L. 100–360 added subsec. (i) relating to transfer to flat prescription drug premiums to Federal Catastrophic Drug Insurance Trust Fund.

Pub. L. 99–53section 8903a of title 51985—Subsec. (d)(1). inserted reference to .

Pub. L. 98–369, § 2663(j)(2)(F)(ii)1984—Subsec. (a)(2). , substituted “Health and Human Services” for “Health, Education, and Welfare”.

Pub. L. 98–369, § 2354(b)(11)Subsec. (d)(1). , substituted “Director of the Office of Personnel Management” for “Civil Service Commission”.

Pub. L. 98–369, § 2663(j)(2)(F)(ii), substituted “Health and Human Services” for “Health, Education, and Welfare”.

Pub. L. 98–369, § 2354(b)(11)Subsec. (d)(2). , substituted “Director of the Office of Personnel Management” for “Civil Service Commission”.

Pub. L. 93–4451974—Subsec. (b)(1). substituted “under the Railroad Retirement Act of 1974” for “or pension under the Railroad Retirement Act of 1937”.

Pub. L. 92–603section 423 of this title1972—Subsec. (a)(1). , §§ 201(c)(6)(A), 263(a), substituted “subsections (b)(1) and (c)” for “subsection (d)” and inserted reference to .

Pub. L. 92–603, § 201(c)(6)(B)section 423 of this titleSubsec. (a)(2). , inserted reference to .

Pub. L. 92–603, § 263(b)section 402 of this titleSubsec. (b)(1). , inserted “(whether or not such individual is also entitled for such month to a monthly insurance benefit under )” after “1937” and substituted “subsection (c)” for “subsection (d)”.

Pub. L. 92–603, § 263(c)section 402 of this titleSubsec. (c). , struck out subsec. (c) covering individuals entitled both to monthly benefits under and to an annuity or pension under Railroad Retirement Act of 1937 and redesignated former subsec. (d) as (c).

Pub. L. 92–603, § 263(c)Subsec. (d). , redesignated subsec. (e) as (d). Former subsec. (d) redesignated (c).

Pub. L. 92–603, § 263(c)Subsec. (e). , (d)(1), redesignated subsec. (f) as (e) and substituted “subsection (c)” for “subsection (d)”. Former subsec. (e) redesignated (d).

Pub. L. 92–603, § 263(c)Subsec. (f). , (d)(2), redesignated subsec. (g) as (f) and substituted “subsections (c) or (e)” for “subsections (d) or (f)”. Former subsec. (f) redesignated (e) and amended.

Pub. L. 92–603, § 263(c)Subsec. (g). , redesignated subsec. (h) as (g). Former subsec. (g) redesignated (f) and amended.

Pub. L. 92–603, § 263(c)Subsecs. (h), (i). , (d)(3), redesignated subsec. (i) as (h) and substituted “(c) and (d)” for “(c), (d), and (e)”. Former subsec. (h) redesignated (g).

Pub. L. 90–2481968—Subsec. (e). provided for reimbursement of civil service retirement annuitants for certain premium payments under supplementary medical insurance program, and substituted “subchapter III of chapter 83 of Title 5 or any other law” and “such other law” for “the Civil Service Retirement Act, or other Act” and “such other Act”, in pars. (1) and (2), respectively.

Pub. L. 89–3841966—Subsec. (i). added subsec. (i).

Statutory Notes and Related Subsidiaries

Change of Name

section 201 of Pub. L. 108–173section 1395w–21 of Title 42References to Medicare+Choice deemed to refer to Medicare Advantage or MA, subject to an appropriate transition provided by the Secretary of Health and Human Services in the use of those terms, see , set out as a note under , The Public Health and Welfare.

Effective Date of 2003 Amendment

Pub. L. 108–173section 223(a) of Pub. L. 108–173section 1395w–21 of this titleAmendment by applicable with respect to plan years beginning on or after , see , set out as a note under .

Effective Date of 2000 Amendment

Pub. L. 106–554Pub. L. 106–554section 1395r of this titleAmendment by applicable to years beginning with 2003, see section 1(a)(6) [title VI, § 606(b)] of , set out as a note under .

Effective Date of 1994 Amendment

Pub. L. 103–296section 110(a) of Pub. L. 103–296section 401 of this titleAmendment by effective , see , set out as a note under .

Effective Date of 1989 Amendment

Pub. L. 101–234section 202(b) of Pub. L. 101–234section 401 of this titleAmendment by effective , see , set out as a note under .

Effective Date of 1988 Amendment

Pub. L. 100–485Pub. L. 100–360section 608(g)(1) of Pub. L. 100–485section 704 of this titleAmendment by effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, , see , set out as a note under .

Effective Date of 1984 Amendment

section 2354(b)(11) 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 .

section 2663(j)(2)(F)(ii) of Pub. L. 98–369section 2664(b) of Pub. L. 98–369section 401 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 1974 Amendment

Pub. L. 93–445section 603 of Pub. L. 93–445section 402 of this titleAmendment by effective , see , set out as a note under .

Effective Date of 1972 Amendment

Pub. L. 92–603, title II, § 263(f)86 Stat. 1449

“The amendments made by this section [amending this section and sections 1395t and 1395u of this title] with respect to collection of premiums shall apply to premiums becoming due and payable after the fourth month following the month in which this Act is enacted [October 1972].”
, , , provided that: