US Code

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

42 U.S.C. § 426

Entitlement to hospital insurance benefits

(a)

Individuals over 65 years

Every individual who—
(1)
has attained age 65, and
(2)
(A)
section 402 of this title is entitled to monthly insurance benefits under , would be entitled to those benefits except that he has not filed an application therefor (or application has not been made for a benefit the entitlement to which for any individual is a condition of entitlement therefor), or would be entitled to such benefits but for the failure of another individual, who meets all the criteria of entitlement to monthly insurance benefits, to meet such criteria throughout a month, and, in conformity with regulations of the Secretary, files an application for hospital insurance benefits under part A of subchapter XVIII,
(B)
is a qualified railroad retirement beneficiary, or
(C)
(i)
section 410(p) of this titlesection 410(a) of this title would meet the requirements of subparagraph (A) upon filing application for the monthly insurance benefits involved if medicare qualified government employment (as defined in ) were treated as employment (as defined in ) for purposes of this subchapter, and (ii) files an application, in conformity with regulations of the Secretary, for hospital insurance benefits under part A of subchapter XVIII,
shall be entitled to hospital insurance benefits under part A of subchapter XVIII for each month for which he meets the condition specified in paragraph (2), beginning with the first month after June 1966 for which he meets the conditions specified in paragraphs (1) and (2).
(b)

Individuals under 65 years

Every individual who—
(1)
has not attained age 65, and
(2)
(A)
section 423 of this titlesection 402(d) of this titlesection 423(d) of this titlesection 402(e) of this titlesection 402(f) of this titlesection 423(d) of this title is entitled to, and has for 24 calendar months been entitled to, (i) disability insurance benefits under or (ii) child’s insurance benefits under by reason of a disability (as defined in ) or (iii) widow’s insurance benefits under or widower’s insurance benefits under by reason of a disability (as defined in ), or
(B)
section 231f(d) of title 45 is, and has been for not less than 24 months, a disabled qualified railroad retirement beneficiary, within the meaning of , or
(C)
(i)
has filed an application, in conformity with regulations of the Secretary, for hospital insurance benefits under part A of subchapter XVIII pursuant to this subparagraph, and
(ii)
would meet the requirements of subparagraph (A) (as determined under the disability criteria, including reviews, applied under this subchapter), including the requirement that he has been entitled to the specified benefits for 24 months, if—
(I)
section 410(p) of this titlesection 410(a) of this title medicare qualified government employment (as defined in ) were treated as employment (as defined in ) for purposes of this subchapter, and
(II)
the filing of the application under clause (i) of this subparagraph were deemed to be the filing of an application for the disability-related benefits referred to in clause (i), (ii), or (iii) of subparagraph (A),
section 422(c)(4)(A) of this titlesection 423(a)(1) of this titlesection 402(d)(1)(G)(i) of this titlesection 402(e)(1) of this titlesection 402(f)(1) of this titleshall be entitled to hospital insurance benefits under part A of subchapter XVIII for each month beginning with the later of (I) July 1973 or (II) the twenty-fifth month of his entitlement or status as a qualified railroad retirement beneficiary described in paragraph (2), and ending (subject to the last sentence of this subsection) with the month following the month in which notice of termination of such entitlement to benefits or status as a qualified railroad retirement beneficiary described in paragraph (2) is mailed to him, or if earlier, with the month before the month in which he attains age 65. In applying the previous sentence in the case of an individual described in paragraph (2)(C), the “twenty-fifth month of his entitlement” refers to the first month after the twenty-fourth month of entitlement to specified benefits referred to in paragraph (2)(C) and “notice of termination of such entitlement” refers to a notice that the individual would no longer be determined to be entitled to such specified benefits under the conditions described in that paragraph. For purposes of this subsection, an individual who has had a period of trial work which ended as provided in , and whose entitlement to benefits or status as a qualified railroad retirement beneficiary as described in paragraph (2) has subsequently terminated, shall be deemed to be entitled to such benefits or to occupy such status (notwithstanding the termination of such entitlement or status) for the period of consecutive months throughout all of which the physical or mental impairment, on which such entitlement or status was based, continues, and throughout all of which such individual would have been entitled to monthly insurance benefits under this subchapter or as a qualified railroad retirement beneficiary had such individual been unable to engage in substantial gainful activity, but not in excess of 78 such months. In determining when an individual’s entitlement or status terminates for purposes of the preceding sentence, the term “36 months” in the second sentence of , in , in the last sentence of , and in the last sentence of shall be applied as though it read “15 months”.
(c)

Conditions

For purposes of subsection (a)—
(1)
section 1395f(f) of this title entitlement of an individual to hospital insurance benefits for a month shall consist of entitlement to have payment made under, and subject to the limitations in, part A of subchapter XVIII on his behalf for inpatient hospital services, post-hospital extended care services, and home health services (as such terms are defined in part E of subchapter XVIII) furnished him in the United States (or outside the United States in the case of inpatient hospital services furnished under the conditions described in ) during such month; except that (A) no such payment may be made for post-hospital extended care services furnished before January 1967, and (B) no such payment may be made for post-hospital extended care services unless the discharge from the hospital required to qualify such services for payment under part A of subchapter XVIII occurred (i) after , or on or after the first day of the month in which he attains age 65, whichever is later, or (ii) if he was entitled to hospital insurance benefits pursuant to subsection (b), at a time when he was so entitled; and
(2)
section 423 of this title an individual shall be deemed entitled to monthly insurance benefits under section 402 or , or to be a qualified railroad retirement beneficiary, for the month in which he died if he would have been entitled to such benefits, or would have been a qualified railroad retirement beneficiary, for such month had he died in the next month.
(d)

“Qualified railroad retirement beneficiary” defined

section 231f(d) of title 45section 231f(d) of title 45For purposes of this section, the term “qualified railroad retirement beneficiary” means an individual whose name has been certified to the Secretary by the Railroad Retirement Board under . An individual shall cease to be a qualified railroad retirement beneficiary at the close of the month preceding the month which is certified by the Railroad Retirement Board as the month in which he ceased to meet the requirements of .

(e)

Benefits for widows and widowers

(1)
(A)
For purposes of determining entitlement to hospital insurance benefits under subsection (b) in the case of widows and widowers described in paragraph (2)(A)(iii) thereof—
(i)
the term “age 60” in sections 402(e)(1)(B)(ii), 402(e)(4), 402(f)(1)(B)(ii), and 402(f)(4) of this title shall be deemed to read “age 65”; and
(ii)
section 402(e)(1) of this titlesection 402(f)(1) of this title the phrase “before she attained age 60” in the matter following subparagraph (F) of and the phrase “before he attained age 60” in the matter following subparagraph (F) of shall each be deemed to read “based on a disability”.
(B)
section 1382e(a) of this titlesection 212(a) of Public Law 93–66section 1382e(a) of this titlesection 212(b) of Public Law 93–66 For purposes of subsection (b)(2)(A)(iii), each month in the period commencing with the first month for which an individual is first eligible for supplemental security income benefits under subchapter XVI, or State supplementary payments of the type referred to in (or payments of the type described in ) which are paid by the Secretary under an agreement referred to in (or in ), shall be included as one of the 24 months for which such individual must have been entitled to widow’s or widower’s insurance benefits on the basis of disability in order to become entitled to hospital insurance benefits on that basis.
(2)
section 402 of this title For purposes of determining entitlement to hospital insurance benefits under subsection (b) in the case of an individual under age 65 who is entitled to benefits under , and who was entitled to widow’s insurance benefits or widower’s insurance benefits based on disability for the month before the first month in which such individual was so entitled to old-age insurance benefits (but ceased to be entitled to such widow’s or widower’s insurance benefits upon becoming entitled to such old-age insurance benefits), such individual shall be deemed to have continued to be entitled to such widow’s insurance benefits or widower’s insurance benefits for and after such first month.
(3)
For purposes of determining entitlement to hospital insurance benefits under subsection (b), any disabled widow aged 50 or older who is entitled to mother’s insurance benefits (and who would have been entitled to widow’s insurance benefits by reason of disability if she had filed for such widow’s benefits), and any disabled widower aged 50 or older who is entitled to father’s insurance benefits (and who would have been entitled to widower’s insurance benefits by reason of disability if he had filed for such widower’s benefits), shall, upon application for such hospital insurance benefits be deemed to have filed for such widow’s or widower’s insurance benefits.
(4)
section 402(j)(4) of this title For purposes of determining entitlement to hospital insurance benefits under subsection (b) in the case of an individual described in clause (iii) of subsection (b)(2)(A), the entitlement of such individual to widow’s or widower’s insurance benefits under section 402(e) or (f) of this title by reason of a disability shall be deemed to be the entitlement to such benefits that would result if such entitlement were determined without regard to the provisions of .
(f)

Medicare waiting period for recipients of disability benefits

section 1395p(g)(1) of this titlesection 231f(d)(2)(ii) of title 45section 1395p(f) of this titleFor purposes of subsection (b) (and for purposes of and ), the 24 months for which an individual has to have been entitled to specified monthly benefits on the basis of disability in order to become entitled to hospital insurance benefits on such basis effective with any particular month (or to be deemed to have enrolled in the supplementary medical insurance program, on the basis of such entitlement, by reason of ), where such individual had been entitled to specified monthly benefits of the same type during a previous period which terminated—
(1)
more than 60 months before the month in which his current disability began in any case where such monthly benefits were of the type specified in clause (A)(i) or (B) of subsection (b)(2), or
(2)
more than 84 months before the month in which his current disability began in any case where such monthly benefits were of the type specified in clause (A)(ii) or (A)(iii) of such subsection,
shall not include any month which occurred during such previous period, unless the physical or mental impairment which is the basis for disability is the same as (or directly related to) the physical or mental impairment which served as the basis for disability in such previous period.
(g)

Information regarding eligibility of Federal employees

section 410(a)(5) of this title1

1 So in original. Probably should be “subchapter III of chapter 83”.
The Secretary and Director of the Office of Personnel Management shall jointly prescribe and carry out procedures designed to assure that all individuals who perform medicare qualified government employment by virtue of service described in are fully informed with respect to (1) their eligibility or potential eligibility for hospital insurance benefits (based on such employment) under part A of subchapter XVIII, (2) the requirements for and conditions of such eligibility, and (3) the necessity of timely application as a condition of entitlement under subsection (b)(2)(C), giving particular attention to individuals who apply for an annuity under chapter 83  of title 5 or under another similar Federal retirement program, and whose eligibility for such an annuity is or would be based on a disability.

(h)

Waiver of waiting period for individuals with ALS

For purposes of applying this section in the case of an individual medically determined to have amyotrophic lateral sclerosis (ALS), the following special rules apply:
(1)
Subsection (b) shall be applied as if there were no requirement for any entitlement to benefits, or status, for a period longer than 1 month.
(2)
The entitlement under such subsection shall begin with the first month (rather than twenty-fifth month) of entitlement or status.
(3)
Subsection (f) shall not be applied.
(i)

Certain uninsured individuals

section 426a of this titleFor entitlement to hospital insurance benefits in the case of certain uninsured individuals, see .

Aug. 14, 1935, ch. 531Pub. L. 89–97, title I, § 10179 Stat. 290Pub. L. 90–248, title I, § 129(c)(1)81 Stat. 847Pub. L. 92–603, title II86 Stat. 1371Pub. L. 93–58, § 387 Stat. 142Pub. L. 93–233, § 18(f)87 Stat. 969Pub. L. 93–445, title III, § 30588 Stat. 1358Pub. L. 95–216, title III91 Stat. 1543Pub. L. 95–29292 Stat. 308Pub. L. 96–265, title I94 Stat. 444Pub. L. 96–473, § 2(a)94 Stat. 2263Pub. L. 96–499, title IX, § 930(q)94 Stat. 2633Pub. L. 97–35, title XXII, § 2203(e)95 Stat. 837Pub. L. 97–248, title II, § 278(b)(2)(A)96 Stat. 560Pub. L. 98–21, title I, § 131(a)(3)(H)97 Stat. 93Pub. L. 98–369, div. B, title VI, § 2663(a)(17)98 Stat. 1165Pub. L. 99–272, title XIII, § 13205(b)(2)(A)100 Stat. 317Pub. L. 100–203, title IV, § 4033(a)101 Stat. 1330–77Pub. L. 100–360, title IV, § 411(e)(2)102 Stat. 775Pub. L. 100–360, title IV, § 411(n)(1)102 Stat. 807Pub. L. 100–485, title VI, § 608(f)(5)102 Stat. 2424Pub. L. 101–508, title V, § 5103(c)(2)(C)104 Stat. 1388–252Pub. L. 103–296, title II, § 201(a)(3)(D)(i)108 Stat. 1497Pub. L. 105–33, title IV, § 4002(f)(1)111 Stat. 329Pub. L. 106–170, title II, § 202(a)113 Stat. 1894Pub. L. 106–554, § 1(a)(6) [title I, § 115(a)]114 Stat. 2763Pub. L. 108–173, title I, § 101(e)(1)117 Stat. 2150Pub. L. 108–203, title IV, § 418(b)(4)(B)(vii)118 Stat. 533Pub. L. 114–74, title VIII, § 844(a)129 Stat. 617(, title II, § 226, as added , , ; amended , , ; , §§ 201(b), 299I, , , 1463; , , ; , , ; , , ; , §§ 332(a)(3), 334(d)(4)(B), , , 1546; , §§ 1(b), 3, , , 315; , §§ 103(a)(1), (b), 104(a), , ; , , ; , , ; , , ; , (B), (4), , , 561; , (b)(3)(G), title III, § 309(q)(1), , , 117; , , ; , (C)(ii), , ; , formerly § 4033(a)(1), title IX, § 9010(e)(3), , , 1330–294, renumbered , , ; , , ; , , ; , , ; , , ; , , ; , , ; , , , 2763A–474; , , ; , , ; , , .)

Editorial Notes

References in Text

Section 212 of Public Law 93–66section 212 of Pub. L. 93–66section 1382 of this title, referred to in subsec. (e)(1)(B), is which is set out as a note under .

Amendments

Pub. L. 114–74section 425(c) of this title2015—Subsecs. (i), (j). redesignated subsec. (j) as (i) and struck out former subsec. (i). Prior to amendment, text of subsec. (i) read as follows: “For purposes of this section, each person whose monthly insurance benefit for any month is terminated or is otherwise not payable solely by reason of paragraph (1) or (7) of shall be treated as entitled to such benefit for such month.”

Pub. L. 108–2032004—Subsec. (e)(1)(A)(i). substituted “402(f)(4)” for “402(f)(5)”.

Pub. L. 108–1732003—Subsec. (c)(1). substituted “part E” for “part D”.

Pub. L. 106–5542000—Subsecs. (h), (j). added subsec. (h) and redesignated former subsec. (h) as (j) and transferred such subsec. to appear at end of section.

Pub. L. 106–1701999—Subsec. (b). substituted “78” for “24” in penultimate sentence.

Pub. L. 105–331997—Subsec. (c)(1). substituted “part D” for “part C”.

Pub. L. 103–2961994—Subsec. (i). added subsec. (i).

Pub. L. 101–5081990—Subsec. (e)(1). designated existing provisions as subpar. (A), redesignated former subpars. (A) and (B) as cls. (i) and (ii), respectively, and added subpar. (B).

Pub. L. 100–4851988—Subsec. (a). substituted “condition specified in paragraph (2)” for “condition specified in paragraph (1)” in concluding provisions.

Pub. L. 100–360, § 411(n)(1)section 423(a) of this titleSubsec. (b). , amended last sentence generally. Prior to amendment, last sentence read as follows: “In determining when an individual’s entitlement or status terminates for purposes of the preceding sentence, the second sentence of shall be applied as though the term ‘36 months’ (in such second sentence) read ‘15 months’.”

Pub. L. 100–203, § 9010(e)(3)1987—Subsec. (b). , inserted sentence at end which related to determining when an individual’s entitlement or status terminates for purposes of preceding sentence.

Pub. L. 100–203, § 4033(a)Subsec. (f). , inserted before period at end “, unless the physical or mental impairment which is the basis for disability is the same as (or directly related to) the physical or mental impairment which served as the basis for disability in such previous period”.

Pub. L. 99–272, § 13205(b)(2)(A)1986—Subsec. (a)(2)(C)(i). substituted “medicare qualified government employment” for “medicare qualified Federal employment”.

Pub. L. 99–272, § 13205(b)(2)(A)Subsec. (b)(2)(C)(ii)(I). , substituted “medicare qualified government employment” for “medicare qualified Federal employment”.

Pub. L. 99–272, § 13205(b)(2)(C)(ii)section 410(a)(5) of this titleSubsec. (g). , substituted “medicare qualified government employment by virtue of service described in ” for “medicare qualified Federal employment”.

Pub. L. 98–3691984—Subsec. (b). substituted “part A” for “part (A)” in provisions following par. (2)(C).

Pub. L. 98–21, § 131(a)(3)(H)1983—Subsec. (e)(1)(A). , (b)(3)(G), substituted reference to section 402(e)(4), (f)(5) of this title for reference to section 402(e)(5), (f)(6) of this title.

Pub. L. 98–21, § 309(q)(1)Subsec. (e)(3). , amended par. (3) generally, inserting provisions relating to any disabled widower and striking out provision that a disabled widow, upon furnishing proof of such disability prior to , under such procedures as the Secretary prescribed, would be deemed to have been entitled to such widow’s benefits as of the time she would have been entitled to such widow’s benefits if she had filed a timely application therefor.

Pub. L. 97–248, § 278(b)(2)(A)1982—Subsec. (a)(2). , redesignated existing provisions as subpar. (A), struck out “or is a qualified railroad retirement beneficiary,” after “subchapter XVIII,”, and added subpars. (B) and (C).

Pub. L. 97–248, § 278(b)(2)(B)Subsec. (b). , in par. (2)(B) inserted a comma after “24 months” and “or” after “title 45,”, added par. (2)(C), and in provisions following par. (2) inserted provision defining “twenty-fifth month of his entitlement” and “notice of termination of such entitlement” with regards to applying first sentence of this subsection to individuals described in par. (2)(C).

Pub. L. 97–248, § 278(b)(4)Subsecs. (g), (h). , added subsec. (g) and redesignated former subsec. (g) as (h).

Pub. L. 97–351981—Subsec. (a)(2). substituted “would be entitled” for “or would be entitled” and inserted “, or would be entitled to such benefits but for the failure of another individual, who meets all the criteria of entitlement to monthly insurance benefits, to meet such criteria throughout a month,”.

Pub. L. 96–4731980—Subsec. (a)(2). inserted provisions relating to persons who would be entitled to benefits but for enumerated exceptions.

Pub. L. 96–265, § 104(a)section 422(c)(4)(A) of this titleSubsec. (b). , in provisions following par. (2), inserted “(subject to the last sentence of this subsection)”, and inserted provision that, for purposes of this subsection, an individual who has had a period of trial work which ended as provided in , and whose entitlement to benefits or status as a qualified railroad retirement beneficiary as described in paragraph (2) has subsequently terminated, shall be deemed to be entitled to such benefits or to occupy such status (notwithstanding the termination of such entitlement or status) for the period of consecutive months throughout all of which the physical or mental impairment, on which such entitlement or status was based, continues, and throughout all of which such individual would have been entitled to monthly insurance benefits under this subchapter.

Pub. L. 96–265, § 103(a)(1), substituted “24 calendar months” and “24 months” for “24 consecutive calendar months” and “24 consecutive months”, respectively, in par. (2) and, in provisions following par. (2), substituted “the twenty-fifth month” for “the twenty-fifth consecutive month”.

Pub. L. 96–499Subsec. (c)(1). substituted “and home health services” for “and post-hospital home health services” and struck out “or post-hospital home health services” before “unless the discharge”.

Pub. L. 96–265, § 103(b)Subsecs. (f), (g). , added subsec. (f) and redesignated former subsec. (f) as (g).

Pub. L. 95–292, § 3(a)1978—Subsec. (a). , substituted “condition specified in paragraph (1), beginning with the first month after June 1966 for which he meets the conditions specified in paragraphs (1) and (2)” for “conditions specified in subparagraph (B), beginning with the first month after June 1966 for which he meets the conditions specified in subparagraphs (A) and (B)”.

Pub. L. 95–292Pub. L. 93–233section 426–1 of this titleSubsec. (e). , §§ 1(b)(1), (2), 3(b), redesignated subsec. (h) as (e) and, in subsec. (e) as so redesignated, corrected a technical error resulting from the 1973 amendment of pars. (2) and (3) by under which a reference to subsec. (b) of this section had been inserted without the required parentheses. Former subsec. (e), relating to Medicare eligibility of persons medically determined to have chronic renal disease requiring hemodialysis or renal transplantation, was struck out. See .

Pub. L. 95–292, § 1(b)(1)section 426–1 of this titleSubsec. (f). , (2), redesignated subsec. (i) as (f). Former subsec. (f), relating to the duration of Medicare coverage of persons medically determined to have chronic renal disease requiring hemodialysis or renal transplantation, was struck out. See .

Pub. L. 95–292, § 1(b)(1)section 1395rr of this titleSubsec. (g). , struck out subsec. (g) which related to reimbursement for kidney transplant and kidney treatment. See .

Pub. L. 95–292, § 1(b)(2)Subsecs. (h), (i). , redesignated subsecs. (h) and (i) as (e) and (f), respectively.

Pub. L. 95–216, § 334(d)(4)(B)1977—Subsec. (h)(1)(B). , substituted “subparagraph (F) of section 402(f)(1)” for “subparagraph (G) of section 402(f)(1)”.

Pub. L. 95–216, § 332(a)(3)Subsec. (h)(4). , added par. (4).

Pub. L. 93–445, § 305(a)1974—Subsec. (b)(2). , substituted “section 7(d) of the Railroad Retirement Act of 1974” for “section 22 of the Railroad Retirement Act of 1937”.

Pub. L. 93–445, § 305(b)Subsec. (d). , substituted “section 7(d) of the Railroad Retirement Act of 1974” for “section 21 or 22 of the Railroad Retirement Act of 1937”, in two places.

Pub. L. 93–445, § 305(c)Subsec. (e). , substituted “Railroad Retirement Act of 1974” for “Railroad Retirement Act of 1937”, wherever appearing.

Pub. L. 93–233, § 18(f)(1)(A)1973—Subsec. (a). , redesignated subsec. (a)(1) as subsec. (a).

Pub. L. 93–233, § 18(f)(1)(B)Subsec. (a)(1), (2). , redesignated cls. (A) and (B) as (1) and (2), respectively.

Pub. L. 93–58section 414 of this titleSubsec. (e)(2). , inserted in: item (2)(A) “or would be fully or currently insured if his service as an employee (as defined in the Railroad Retirement Act of 1937) after , were included in the term ‘employment’ as defined in this chapter” after “(as such terms are defined in )”; item (2)(B) “or an annuity under the Railroad Retirement Act of 1937” after “this subchapter”; item (2)(C) “Or would be fully or currently insured if his service as an employee (as defined in the Railroad Retirement Act of 1937) after , were included in the term ‘employment’ as defined in this chapter” after “fully or currently insured”; and item (2)(D) “or annuity under the Railroad Retirement Act of 1937” after “this subchapter”.

Pub. L. 93–233, § 18(f)(1)(C)section 201(b)(5) of Pub. L. 92–603section 299I of Pub. L. 92–603section 402(f)(1) of this titleSubsec. (h). , (2)–(4), redesignated as subsec. (h) provisions originally enacted as subsec. (e) by and redesignated as subsec. (f) by , and in par. (1)(A) substituted “, 402(e)(5),” for “and 402(e)(5) of this title, and the term ‘age 62’ in sections”, in par. (1)(B) substituted “and the phrase ‘before he attained age 60’ in the matter following subparagraph (G) of shall each” for “shall”, and in pars. (2) and (3) substituted “(b)” for “(a)(2)”, respectively.

Pub. L. 93–233, § 18(f)(1)(C)section 101 of Pub. L. 89–97section 201(b)(5) of Pub. L. 92–603Subsec. (i). , redesignated as subsec. (i) provisions originally enacted as subsec. (d) by and redesignated as subsec. (f) by .

Pub. L. 92–603, § 201(b)(1)1972—Subsec. (a). , incorporated provisions of former subsec. (a) and subsec. (a)(1), and redesignated pars. (1) and (2) as subpars. (A) and (B).

Pub. L. 92–603, § 201(b)(1)Subsec. (b). , added subsec. (b). Former subsec. (b) redesignated subsec. (c).

Pub. L. 92–603, § 201(b)(2)Subsec. (c)(1). , (5), redesignated subsec. (b)(1) as subsec. (c)(1) and, in subsec. (c)(1) as so redesignated, inserted reference to entitlement to hospital insurance benefits pursuant to subsec. (b) of this section. Former subsec. (c) redesignated subsec. (d).

Pub. L. 92–603, § 201(b)(3)section 423 of this titleSubsec. (c)(2). , (5), redesignated subsec. (b)(2) as subsec. (c)(2) and inserted reference to . Former subsec. (c) redesignated subsec. (d).

Pub. L. 92–603, § 201(b)(4)Subsec. (d). , (5), redesignated former subsec. (c) as subsec. (d) and inserted reference to section 22 of the Railroad Retirement Act of 1937. Former subsec. (d) redesignated subsec. (i).

Pub. L. 92–603Subsecs. (e) to (h). , §§ 201(b)(5), 299I, added subsecs. (e) to (h). See 1973 Amendment note above.

Pub. L. 92–603, § 201(b)(5)Subsec. (i). , redesignated former subsec. (d) as subsec. (i). See 1973 Amendment note above.

Pub. L. 90–2481968—Subsec. (b)(1). struck out outpatient hospital diagnostic services from services for which hospital insurance benefits are payable.

Statutory Notes and Related Subsidiaries

Effective Date of 2004 Amendment

Pub. L. 108–203section 418(c) of Pub. L. 108–203section 402 of this titleAmendment by applicable with respect to applications for benefits under this subchapter filed on or after the first day of the first month that begins after , see , set out as a note under .

Effective Date of 2000 Amendment

Pub. L. 106–554, § 1(a)(6) [title I, § 115(c)]114 Stat. 2763

section 1395p of this title“The amendments made by this section [amending this section and ] shall apply to benefits for months beginning .”
, , , 2763A–474, provided that:

Effective Date of 1999 Amendment

Pub. L. 106–170, title II, § 202(b)113 Stat. 1894

“The amendment made by subsection (a) [amending this section] shall be effective on and after .”
, , , provided that:

Effective Date of 1994 Amendment

Pub. L. 103–296section 425(c)(9) of this titlesection 201(a)(3)(E)(i) of Pub. L. 103–296section 425 of this titleAmendment by applicable with respect to benefits based on disability (as defined in ) which are otherwise payable in months beginning after 180 days after , with Secretary of Health and Human Services to issue regulations necessary to carry out such amendment not later than 180 days after , see , set out as an Effective Date of 1994 Amendment; Sunset Provision note under .

Effective Date of 1990 Amendment

Pub. L. 101–508section 5103(e) of Pub. L. 101–508section 402 of this titleAmendment by applicable with respect to items and services furnished after December 1990, see , set out as a note under .

Effective Date of 1988 Amendment

Pub. L. 100–485, title VI, § 608(f)(5)102 Stat. 2424Pub. L. 95–292, , , provided that the amendment made by such section 608(f)(5) is effective as of the date of enactment of , which was approved .

section 411 of Pub. L. 100–360Pub. L. 100–360Pub. L. 100–203Pub. L. 100–203section 411(a) of Pub. L. 100–360section 106 of Title 1Except as specifically provided in , amendment by , as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, , effective as if included in the enactment of that provision in , see , set out as a Reference to OBRA; Effective Date note under , General Provisions.

Effective Date of 1987 Amendment

Pub. L. 100–203, title IV, § 4033(b)101 Stat. 1330–77Pub. L. 100–360, title IV, § 411(e)(2)102 Stat. 775

“(1)
The amendment made by subsection (a) [amending this section] shall apply to months beginning after the end of the 60-day period beginning on the date of enactment of this Act [].
“(2)
42 U.S.C. 426(f) The amendment made by subsection (a) shall not apply so as to include (for the purposes described in section 226(f) of the Social Security Act []) monthly benefits paid for any month in a previous period (described in that section) that terminated before the end of the 60-day period described in paragraph (1).”
, formerly § 4033(a)(2), , , as renumbered by , , , provided that:

section 9010(e)(3) of Pub. L. 100–203section 9010 of Pub. L. 100–203section 9010(f) of Pub. L. 100–203section 402 of this titleAmendment by effective , and applicable with respect to individuals entitled to benefits under specific provisions of sections 402 and 423 of this title for any month after December 1987, and individuals entitled to benefits payable under specific provisions of sections 402 and 423 of this title for any month before January 1988 and with respect to whom the 15-month period described in the applicable provision amended by has not elapsed as of , see , set out as a note under .

Effective Date of 1986 Amendment

Pub. L. 99–272section 13205(d)(2) of Pub. L. 99–272section 410 of this titleAmendment by effective after , with no individual to be considered under disability for any period beginning before , for purposes of hospital insurance benefits, see , set out as a note under .

Effective Date of 1984 Amendment

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 1983 Amendment

Pub. L. 98–21section 131(d) of Pub. L. 98–21section 402 of this titleAmendment by section 131(a)(3)(H), (b)(3)(G) of effective with respect to monthly benefits payable under this subchapter for months after December 1983, and in the case of an individual who was not entitled to a monthly benefit of the type involved under this subchapter for December 1983, no benefit shall be paid under this subchapter by reason of such amendments unless proper application for such benefit is made, see set out as a note under .

section 309(q)(1) of Pub. L. 98–21section 310 of Pub. L. 98–21section 402 of this titleAmendment by applicable only with respect to monthly payments payable under this subchapter for months after April 1983, see , set out as a note under .

Pub. L. 97–448, title III, § 309(c)(1)96 Stat. 2410

Pub. L. 97–24896 Stat. 324o“Any amendment to the Tax Equity and Fiscal Responsibility Act of 1982 [, , ] made by this section [amending sections 1395x, 1395cc, and 1396a of this title and amending provisions set out as notes under this section and sections 1320c, 1395b–1, 1395f, 1395u, 1395ww, 1395xx, and 1396 of this title] shall be effective as if it had been originally included in the provision of such Act to which such amendment relates.”
, , , provided that:

Effective Date of 1982 Amendment; Transitional Provisions

Pub. L. 97–248, title II, § 278(c)(2)96 Stat. 562Pub. L. 97–448, title III, § 309(a)(10)96 Stat. 2408

“(c)

Effective Dates.—

“(2)

Medicare coverage.—

“(A)

In general.—

section 426–1 of this titleThe amendments made by subsection (b) [amending this section and sections 410, 426–1, and 1395c of this title] are effective on and after , and the amendments made by paragraph (2) of that subsection [amending this section and ] apply to remuneration (for medicare qualified Federal employment) paid after .
“(B)

Treatment of current disabilities.—

42 U.S.C. 1395cFor purposes of establishing entitlement to hospital insurance benefits under part A of title XVIII of the Social Security Act [ et seq.] pursuant to the amendments made by subsection (b) or the provisions of subsection (d), no individual may be considered to be under a disability for any period before .
“(d)

Transitional Provisions.—

“(1)

In general.—

42 U.S.C. 42642 U.S.C. 410(p)42 U.S.C. 40142 U.S.C. 1395cFor purposes of sections 226, 226A, and 1811 of the Social Security Act [, 426–1, 1395c], in the case of any individual who performs service both during January 1983, and before , which constitutes medicare qualified Federal employment (as defined in section 210(p) of such Act []), the individual’s medicare qualified Federal employment (as so defined) performed before , for which remuneration was paid before such date, shall be considered to be ‘employment’ (as defined for purposes of title II of such Act [ et seq.]), but only for the purpose of providing the individual (or another person) with entitlement to hospital insurance benefits under part A of title XVIII of such Act [ et seq.].
“(2)

Appropriations.—

There are authorized to be appropriated to the Federal Hospital Insurance Trust Fund from time to time such sums as the Secretary of Health and Human Services deems necessary for any fiscal year, on account of—
“(A)
42 U.S.C. 1395 payments made or to be made during such fiscal year from such Trust Fund with respect to individuals who are entitled to benefits under title XVIII of the Social Security Act [ et seq.] solely by reason of paragraph (1) of this subsection,
“(B)
the additional administrative expenses resulting or expected to result therefrom, and
“(C)
any loss in interest to such Trust Fund resulting from the payment of those amounts,
in order to place such Trust Fund in the same position at the end of such fiscal year as it would have been in if this subsection had not been enacted.”
, (d), , , as amended by , (11), , , provided that:

Effective Date of 1981 Amendment

Pub. L. 97–35, title XXII, § 2203(f)(3)95 Stat. 837Pub. L. 97–248, title I, § 128(c)(2)96 Stat. 367

“The amendments made by subsection (e) of this section [amending this section] shall apply only to individuals aged 65 and over whose insured spouse attains age 62 after August 1981.”
, , , as amended by , , , provided that:

Effective Date of 1980 Amendment

Pub. L. 96–499section 930(s)(1) of Pub. L. 96–499section 1395x of this titleAmendment by effective with respect to services furnished on or after , see , set out as a note under .

Pub. L. 96–473, § 2(d)94 Stat. 2264

section 1395c of this title“The amendments made by subsections (a) and (b) [amending this section and ] shall be effective after the second month beginning after the date on which this Act is enacted [].”
, , , provided that:

Pub. L. 96–265, title I, § 103(c)94 Stat. 444

section 231f of Title 45“The amendments made by this section [amending this section and sections 1395c and 1395p of this title and , Railroads] shall apply 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 the date of the enactment of this Act [].”
, , , provided that:

Pub. L. 96–265, title I, § 104(b)94 Stat. 445

“The amendments made by subsection (a) [amending this section] shall become effective on the first day of the sixth month which begins after the date of the enactment of this Act [], and shall apply with respect to any individual whose disability has not been determined to have ceased prior to such first day.”
, , , provided that:

Effective Date of 1978 Amendment

Pub. L. 95–292, § 692 Stat. 315

l“The amendments made by the preceding sections of this Act [enacting sections 426–1 and 1395rr of this title and amending this section and sections 1395c, 1395i, 1395, 1395t, 1395x, 1395cc, and 1395mm of this title] shall become effective with respect to services, supplies, and equipment furnished after the third calendar month which begins after the date of the enactment of this Act [], except that those amendments providing for the implementation of an incentive reimbursement system for dialysis services furnished in facilities and providers shall become effective with respect to a facility’s or provider’s first accounting period which begins after the last day of the twelfth month following the month of the enactment of this Act [June 1978], and those amendments providing for reimbursement rates for home dialysis shall become effective on .”
, , , provided that:

Effective Date of 1977 Amendment

section 332(a)(3) of Pub. L. 95–216section 332(b) of Pub. L. 95–216section 402 of this titleAmendment by effective with respect to monthly insurance benefits under this subchapter to which an individual becomes entitled on the basis of an application filed on or after , see , set out as a note under .

section 334(d)(4)(B) of Pub. L. 95–216section 334(f) of Pub. L. 95–216section 402 of this titleAmendment by applicable with respect to monthly insurance benefits payable under this subchapter for months beginning with December 1977, on the basis of applications filed in or after December 1977, 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 1973 Amendment

Pub. L. 93–58, § 4(a)87 Stat. 142

Public Law 92–60345 U.S.C. 228c(e)(xi)45 U.S.C. 228c(e)(xi)45 U.S.C. 228c(e)(xii)Public Law 92–60342 U.S.C. 402(w)“The provisions of this Act [amending this section and sections 228c and 228e of Title 45, Railroads], except the provisions of section 1, shall be effective as of the date the corresponding provisions of are effective as follows: clause (xi) [] effective with respect to services provided on and after . The provisions of clauses (xi) and (xii), which are added by section 1 of this Act, shall be effective as follows: clause (xi) [] shall be effective with respect to calendar years after 1971 for annuities accruing after December 1972; and clause (xii) [] shall be effective as of the date the delayed retirement provision of is effective [ applicable with respect to old-age insurance benefits payable under this subchapter for months beginning after 1972].”
, , , provided that:

Effective Date of 1972 Amendment

Pub. L. 92–603, title II, § 299I86 Stat. 1463, , , provided that the amendment made by that section is effective with respect to services provided on and after .

Effective Date of 1968 Amendment

Pub. L. 90–248section 129(d) of Pub. L. 90–248section 1395d of this titleAmendment by applicable with respect to services furnished after , see , set out as a note under .

Pub. L. 96–473Applicability of to Applications for Hospital Insurance Benefits

Pub. L. 96–473, § 2(c)94 Stat. 2263

42 U.S.C. 42642 U.S.C. 402section 2(c) of Pub. L. 96–47342 U.S.C. 1395c“For purposes of section 226 of such Act [] as amended by subsection (a) of this section, an individual who filed an application for monthly insurance benefits under section 202 of such Act [] prior to the effective date of the amendment made by subsection (a) [see , set out above as an Effective Date of 1980 Amendment note] shall be deemed to have filed an application for hospital insurance benefits under part A of title XVIII of such Act [ et seq.] at the time he applied for such benefits under section 202 regardless of the continuing status or effect of the application for benefits under section 202, if he would have been entitled to benefits under that section had such application remained in effect.”
, , , provided that:

GAO Report

Pub. L. 106–170, title II, § 202(c)113 Stat. 1894

“Not later than 5 years after the date of the enactment of this Act [], the Comptroller General of the United States shall submit a report to the Congress that—
“(1)
examines the effectiveness and cost of the amendment made by subsection (a) [amending this section];
“(2)
42 U.S.C. 426(b)42 U.S.C. 430 examines the necessity and effectiveness of providing continuation of medicare coverage under section 226(b) of the Social Security Act () to individuals whose annual income exceeds the contribution and benefit base (as determined under section 230 of such Act ());
“(3)
examines the viability of providing the continuation of medicare coverage under such section 226(b) based on a sliding scale premium for individuals whose annual income exceeds such contribution and benefit base;
“(4)
examines the viability of providing the continuation of medicare coverage under such section 226(b) based on a premium buy-in by the beneficiary’s employer in lieu of coverage under private health insurance;
“(5)
examines the interrelation between the use of the continuation of medicare coverage under such section 226(b) and the use of private health insurance coverage by individuals during the extended period; and
“(6)
recommends such legislative or administrative changes relating to the continuation of medicare coverage for recipients of social security disability benefits as the Comptroller General determines are appropriate.”
, , , provided that:

Time in Which To Furnish Proof of Disability for Hospital Benefits

Pub. L. 98–21, title III, § 309(q)(2)97 Stat. 117

42 U.S.C. 426(e)(3)“For purposes of determining entitlement to hospital insurance benefits under section 226(e)(3) of such Act [], as amended by paragraph (1), an individual becoming entitled to such hospital insurance benefits as a result of the amendment made by such paragraph shall, upon furnishing proof of his or her disability within twelve months after the month in which this Act is enacted [April 1983], under such procedures as the Secretary of Health and Human Services may prescribe, be deemed to have been entitled to the widow’s or widower’s benefits referred to in such section 226(e)(3), as so amended, as of the time such individual would have been entitled to such widow’s or widower’s benefits if he or she had filed a timely application therefor.”
, , , provided that:

Special $50 Payment Under Tax Reduction Act of 1975

section 702 of Pub. L. 94–12section 402 of this titleSpecial payment of $50 as soon as practicable after , by the Secretary of the Treasury to each individual who, for the month of March 1975, was entitled to a monthly insurance benefit payable under this subchapter, see , set out as a note under .

Adopted Child’s Reenlistment to Annuity

Pub. L. 93–58, § 4(b)87 Stat. 142

45 U.S.C. 228e(c)45 U.S.C. 228el45 U.S.C. 228el“Any child (1) whose entitlement to an annuity under section 5(c) of the Railroad Retirement Act [of 1937] [former ] was terminated by reason of his adoption prior to the enactment of this Act [], and (2) who, except for such adoption, would be entitled to an annuity under such section for a month after the month in which this Act is enacted [July 1973], may, upon filing application for an annuity under the Railroad Retirement Act [former et seq.] after the date of enactment of this Act [], become reentitled to such annuity; except that no child shall, by reason of the enactment of this Act [amending this section and sections 228c, 228e of Title 45] become reentitled to such annuity for any month prior to the effective date of the relevant amendments made by this Act to section 5()(1)(ii) of the Railroad Retirement Act [former ()(1)(ii)].”
, , , provided that: