
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-554 Section 1(a)(6)]
[Document affected by Public Law 106-554 Section 1(a)(6)[606(b)]]
[CITE: 42USC1395r]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
        SUBCHAPTER XVIII--HEALTH INSURANCE FOR AGED AND DISABLED
 
 Part B--Supplementary Medical Insurance Benefits for Aged and Disabled
 
Sec. 1395r. Amount of premiums for individuals enrolled under 
        this part
        

(a) Determination of monthly actuarial rates and premiums

    (1) The Secretary shall, during September of 1983 and of each year 
thereafter, determine the monthly actuarial rate for enrollees age 65 
and over which shall be applicable for the succeeding calendar year. 
Such actuarial rate shall be the amount the Secretary estimates to be 
necessary so that the aggregate amount for such calendar year with 
respect to those enrollees age 65 and older will equal one-half of the 
total of the benefits and administrative costs which he estimates will 
be payable from the Federal Supplementary Medical Insurance Trust Fund 
for services performed and related administrative costs incurred in such 
calendar year with respect to such enrollees. In calculating the monthly 
actuarial rate, the Secretary shall include an appropriate amount for a 
contingency margin.
    (2) The monthly premium of each individual enrolled under this part 
for each month after December 1983 shall, except as provided in 
subsections (b), (c), and (f) of this section, be the amount determined 
under paragraph (3).
    (3) The Secretary, during September of each year, shall determine 
and promulgate a monthly premium rate for the succeeding calendar year 
that (except as provided in subsection (g) of this section) is equal to 
50 percent of the monthly actuarial rate for enrollees age 65 and over, 
determined according to paragraph (1), for that succeeding calendar 
year. Whenever the Secretary promulgates the dollar amount which shall 
be applicable as the monthly premium rate for any period, he shall, at 
the time such promulgation is announced, issue a public statement 
setting forth the actuarial assumptions and bases employed by him in 
arriving at the amount of an adequate actuarial rate for enrollees age 
65 and older as provided in paragraph (1).
    (4) The Secretary shall also, during September of 1983 and of each 
year thereafter, determine the monthly actuarial rate for disabled 
enrollees under age 65 which shall be applicable for the succeeding 
calendar year. Such actuarial rate shall be the amount the Secretary 
estimates to be necessary so that the aggregate amount for such calendar 
year with respect to disabled enrollees under age 65 which will equal 
one-half of the total of the benefits and administrative costs which he 
estimates will be payable from the Federal Supplementary Medical 
Insurance Trust Fund for services performed and related administrative 
costs incurred in such calendar year with respect to such enrollees. In 
calculating the monthly actuarial rate under this paragraph, the 
Secretary shall include an appropriate amount for a contingency margin.

(b) Increase in monthly premium

    In the case of an individual whose coverage period began pursuant to 
an enrollment after his initial enrollment period (determined pursuant 
to subsection (c) or (d) of section 1395p of this title) and not 
pursuant to a special enrollment period under section 1395p(i)(4) of 
this title, the monthly premium determined under subsection (a) of this 
section shall be increased by 10 percent of the monthly premium so 
determined for each full 12 months (in the same continuous period of 
eligibility) in which he could have been but was not enrolled. For 
purposes of the preceding sentence, there shall be taken into account 
(1) the months which elapsed between the close of his initial enrollment 
period and the close of the enrollment period in which he enrolled, plus 
(in the case of an individual who reenrolls) (2) the months which 
elapsed between the date of termination of a previous coverage period 
and the close of the enrollment period in which he reenrolled, but there 
shall not be taken into account months for which the individual can 
demonstrate that the individual was enrolled in a group health plan 
described in section 1395y(b)(1)(A)(v) of this title by reason of the 
individual's (or the individual's spouse's) current employment status or 
months during which the individual has not attained the age of 65 and 
for which the individual can demonstrate that the individual was 
enrolled in a large group health plan (as that term is defined in 
section 1395y(b)(1)(B)(iii) of this title) by reason of the individual's 
current employment status (or the current employment status of a family 
member of the individual). Any increase in an individual's monthly 
premium under the first sentence of this subsection with respect to a 
particular continuous period of eligibility shall not be applicable with 
respect to any other continuous period of eligibility which such 
individual may have.

(c) Premiums rounded to nearest multiple of ten cents

    If any monthly premium determined under the foregoing provisions of 
this section is not a multiple of 10 cents, such premium shall be 
rounded to the nearest multiple of 10 cents.

(d) ``Continuous period of eligibility'' defined

    For purposes of subsection (b) of this section (and section 
1395p(g)(1) of this title), an individual's ``continuous period of 
eligibility'' is the period beginning with the first day on which he is 
eligible to enroll under section 1395o of this title and ending with his 
death; except that any period during all of which an individual 
satisfied paragraph (1) of section 1395o of this title and which 
terminated in or before the month preceding the month in which he 
attained age 65 shall be a separate ``continuous period of eligibility'' 
with respect to such individual (and each such period which terminates 
shall be deemed not to have existed for purposes of subsequently 
applying this section).

(e) State payment of part B late enrollment premium increases

    (1) Upon the request of a State (or any appropriate State or local 
governmental entity specified by the Secretary), the Secretary may enter 
into an agreement with the State (or such entity) under which the State 
(or such entity) agrees to pay on a quarterly or other periodic basis to 
the Secretary (to be deposited in the Treasury to the credit of the 
Federal Supplementary Medical Insurance Trust Fund) an amount equal to 
the amount of the part B late enrollment premium increases with respect 
to the premiums for eligible individuals (as defined in paragraph 
(3)(A)).
    (2) No part B late enrollment premium increase shall apply to an 
eligible individual for premiums for months for which the amount of such 
an increase is payable under an agreement under paragraph (1).
    (3) In this subsection:
        (A) The term ``eligible individual'' means an individual who is 
    enrolled under this part B and who is within a class of individuals 
    specified in the agreement under paragraph (1).
        (B) The term ``part B late enrollment premium increase'' means 
    any increase in a premium as a result of the application of 
    subsection (b) of this section.

(f) Limitation on increase in monthly premium

    For any calendar year after 1988, if an individual is entitled to 
monthly benefits under section 402 or 423 of this title or to a monthly 
annuity under section 3(a), 4(a), or 4(f) of the Railroad Retirement Act 
of 1974 [45 U.S.C. 231b(a), 231c(a), (f)] for November and December of 
the preceding year, and if the monthly premium of the individual under 
this section for December and for January is deducted from those 
benefits under section 1395s(a)(1) of this title or section 1395s(b)(1) 
of this title, the monthly premium otherwise determined under this 
section for an individual for that year shall not be increased, pursuant 
to this subsection, to the extent that such increase would reduce the 
amount of benefits payable to that individual for that December below 
the amount of benefits payable to that individual for that November 
(after the deduction of the premium under this section). For purposes of 
this subsection, retroactive adjustments or payments and deductions on 
account of work shall not be taken into account in determining the 
monthly benefits to which an individual is entitled under section 402 or 
423 of this title or under the Railroad Retirement Act of 1974 [45 
U.S.C. 231 et seq.].

(g) Exclusions from estimate of benefits and administrative costs

    In estimating the benefits and administrative costs which will be 
payable from the Federal Supplementary Medical Insurance Trust Fund for 
a year for purposes of determining the monthly premium rate under 
subsection (a)(3) of this section, the Secretary shall exclude an 
estimate of any benefits and administrative costs attributable to the 
application of section 1395x(v)(1)(L)(viii) of this title or to the 
establishment under section 1395x(v)(1)(L)(i)(V) of this title of a per 
visit limit at 106 percent of the median (instead of 105 percent of the 
median), but only to the extent payment for home health services under 
this subchapter is not being made under section 1395fff of this title 
(relating to prospective payment for home health services).

(Aug. 14, 1935, ch. 531, title XVIII, Sec. 1839, as added Pub. L. 89-97, 
title I, Sec. 102(a), July 30, 1965, 79 Stat. 305; amended Pub. L. 90-
248, title I, Sec. 145(d), Jan. 2, 1968, 81 Stat. 859; Pub. L. 92-603, 
title II, Secs. 201(c)(4), (5), 203 (a)-(d), Oct. 30, 1972, 86 Stat. 
1373, 1376, 1377; Pub. L. 94-182, title I, Sec. 104(a), Dec. 31, 1975, 
89 Stat. 1052; Pub. L. 95-216, title II, Sec. 205(e), Dec. 20, 1977, 91 
Stat. 1529; Pub. L. 96-499, title IX, Sec. 945(c)(2), Dec. 5, 1980, 94 
Stat. 2642; Pub. L. 97-35, title XXI, Sec. 2151(a)(4), Aug. 13, 1981, 95 
Stat. 802; Pub. L. 97-248, title I, Sec. 124(a), (b), Sept. 3, 1982, 96 
Stat. 364; Pub. L. 97-448, title III, Sec. 309(b)(8), Jan. 12, 1983, 96 
Stat. 2409; Pub. L. 98-21, title VI, Sec. 606(a)(1)-(3)(C), Apr. 20, 
1983, 97 Stat. 169, 170; Pub. L. 98-369, div. B, title III, 
Secs. 2302(a), (b), 2338(a), July 18, 1984, 98 Stat. 1063, 1091; Pub. L. 
98-617, Sec. 3(b)(4), Nov. 8, 1984, 98 Stat. 3295; Pub. L. 99-272, title 
IX, Secs. 9219(a)(1), 9313, Apr. 7, 1986, 100 Stat. 182, 194; Pub. L. 
99-509, title IX, Secs. 9001(c), 9319(c)(4), Oct. 21, 1986, 100 Stat. 
1970, 2012; Pub. L. 100-203, title IV, Sec. 4080, Dec. 22, 1987, 101 
Stat. 1330-126; Pub. L. 100-360, title II, Sec. 211(a)-(c)(1), July 1, 
1988, 102 Stat. 733, 738; Pub. L. 100-485, title VI, Sec. 608(d)(9), 
Oct. 13, 1988, 102 Stat. 2415; Pub. L. 101-234, title II, Sec. 202(a), 
Dec. 13, 1989, 103 Stat. 1981; Pub. L. 101-239, title VI, 
Secs. 6202(b)(4)(C), (c)(2), 6301, Dec. 19, 1989, 103 Stat. 2233, 2234, 
2258; Pub. L. 101-508, title IV, Sec. 4301, Nov. 5, 1990, 104 Stat. 
1388-125; Pub. L. 103-66, title XIII, Sec. 13571, Aug. 10, 1993, 107 
Stat. 609; Pub. L. 103-432, title I, Secs. 144, 151(c)(3), Oct. 31, 
1994, 108 Stat. 4427, 4435; Pub. L. 105-33, title IV, Secs. 4571(a), 
(b)(1), 4581(a), 4582, 4631(a)(2), Aug. 5, 1997, 111 Stat. 464, 465, 
486; Pub. L. 105-277, div. J, title V, Sec. 5101(e), Oct. 21, 1998, 112 
Stat. 2681-915.)

                       References in Text

    The Railroad Retirement Act of 1974, referred to in subsec. (f), is 
act Aug. 29, 1935, ch. 812, as amended generally by Pub. L. 93-445, 
title I, Sec. 101, Oct. 16, 1974, 88 Stat. 1305, which is classified 
generally to subchapter IV (Sec. 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 section 231 of 
Title 45, section 231t of Title 45, and Tables.


                               Amendments

    1998--Subsec. (a)(3). Pub. L. 105-277, Sec. 5101(e)(1), inserted 
``(except as provided in subsection (g) of this section)'' after ``year 
that''.
    Subsec. (g). Pub. L. 105-277, Sec. 5101(e)(2), added subsec. (g).
    1997--Subsec. (a)(2). Pub. L. 105-33, Sec. 4571(b)(1)(A), 
substituted ``subsections (b), (c), and (f)'' for ``subsections (b) and 
(e)''.
    Subsec. (a)(3). Pub. L. 105-33, Sec. 4571(b)(1)(B), in last 
sentence, inserted ``rate'' after ``monthly premium'' and struck out 
``and the derivation of the dollar amounts specified in this paragraph'' 
before period at end.
    Pub. L. 105-33, Sec. 4571(a), substituted ``The Secretary, during 
September of each year, shall determine and promulgate a monthly premium 
rate for the succeeding calendar year that is equal to 50 percent of the 
monthly actuarial rate for enrollees age 65 and over, determined 
according to paragraph (1), for that succeeding calendar year.'' for 
``The Secretary shall, during September of 1983 and of each year 
thereafter, determine and promulgate the monthly premium applicable for 
individuals enrolled under this part for the succeeding calendar year. 
The monthly premium shall (except as otherwise provided in subsection 
(e) of this section) be equal to the smaller of--
        ``(A) the monthly actuarial rate for enrollees age 65 and over, 
    determined according to paragraph (1) of this subsection, for that 
    calendar year, or
        ``(B) the monthly premium rate most recently promulgated by the 
    Secretary under this paragraph, increased by a percentage determined 
    as follows: The Secretary shall ascertain the primary insurance 
    amount computed under section 415(a)(1) of this title, based upon 
    average indexed monthly earnings of $900, that applied to 
    individuals who became eligible for and entitled to old-age 
    insurance benefits on November 1 of the year before the year of the 
    promulgation. He shall increase the monthly premium rate by the same 
    percentage by which that primary insurance amount is increased when, 
    by reason of the law in effect at the time the promulgation is made, 
    it is so computed to apply to those individuals for the following 
    November 1.''
    Subsec. (b). Pub. L. 105-33, Sec. 4631(a)(2), substituted 
``1395y(b)(1)(B)(iii) of this title'' for ``1395y(b)(1)(B)(iv) of this 
title'' in second sentence.
    Pub. L. 105-33, Sec. 4571(b)(1)(C), struck out ``or (e)'' after 
``determined under subsection (a)'' in first sentence.
    Pub. L. 105-33, Sec. 4581(a), inserted ``and not pursuant to a 
special enrollment period under section 1395p(i)(4) of this title'' 
after ``section 1395p of this title)'' in first sentence.
    Subsec. (e). Pub. L. 105-33, Sec. 4571(b)(1)(D), (E), redesignated 
subsec. (g) as (e) and struck out former subsec. (e) which read as 
follows:
    ``(1)(A) Notwithstanding the provisions of subsection (a) of this 
section, the monthly premium for each individual enrolled under this 
part for each month after after December 1995 and prior to January 1999 
shall be an amount equal to 50 percent of the monthly actuarial rate for 
enrollees age 65 and over, as determined under subsection (a)(1) of this 
section and applicable to such month.
    ``(B) Notwithstanding the provisions of subsection (a) of this 
section, the monthly premium for each individual enrolled under this 
part for each month in--
        ``(i) 1991 shall be $29.90,
        ``(ii) 1992 shall be $31.80,
        ``(iii) 1993 shall be $36.60,
        ``(iv) 1994 shall be $41.10, and
        ``(v) 1995 shall be $46.10.
    ``(2) Any increases in premium amounts taking effect prior to 
January 1998 by reason of paragraph (1) shall be taken into account for 
purposes of determining increases thereafter under subsection (a)(3) of 
this section.''
    Subsec. (e)(1). Pub. L. 105-33, Sec. 4582, inserted ``(or any 
appropriate State or local governmental entity specified by the 
Secretary)'' after ``request of a State'' and inserted ``(or such 
entity)'' after ``agreement with the State'' and after ``which the 
State''.
    Subsec. (g). Pub. L. 105-33, Sec. 4571(b)(1)(E), redesignated 
subsec. (g) as (e).
    1994--Subsec. (b). Pub. L. 103-432, Sec. 151(c)(3), in second 
sentence, inserted ``status'' after ``current employment'' and 
substituted ``(as that term is defined in section 1395y(b)(1)(B)(iv) of 
this title) 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 section 
1395y(b)(1)(B)(iv) of this title)''.
    Subsec. (g). Pub. L. 103-432, Sec. 144, added subsec. (g).
    1993--Subsec. (e)(1)(A). Pub. L. 103-66, Sec. 13571(1), substituted 
``after December 1995 and prior to January 1999 shall be an amount equal 
to 50 percent'' for ``December 1983 and prior to January 1991 shall be 
an amount equal to 50 percent''.
    Subsec. (e)(2). Pub. L. 103-66, Sec. 13571(2), substituted ``1998'' 
for ``1991''.
    1990--Subsec. (e)(1). Pub. L. 101-508 designated existing provisions 
as subpar. (A) and added subpar. (B).
    1989--Subsec. (a). Pub. L. 101-234 repealed Pub. L. 100-360, 
Sec. 211(c)(1)(A)-(D), 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 notes below.
    Subsec. (b). Pub. L. 101-239, Sec. 6202(c)(2), struck out ``during 
which the individual has attained the age of 65 and'' after ``into 
account months'' in second sentence.
    Pub. L. 101-239, Sec. 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. 101-234 repealed Pub. L. 100-360, Sec. 211(c)(1)(E), 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.
    Subsec. (e). Pub. L. 101-239, Sec. 6301, substituted ``1991'' for 
``1990'' wherever appearing.
    Subsec. (e)(1). Pub. L. 101-234 repealed Pub. L. 100-360, 
Sec. 211(c)(1)(F), 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.
    Subsec. (g). Pub. L. 101-234 repealed Pub. L. 100-360, Sec. 211(a), 
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.
    1988--Subsec. (a)(1). Pub. L. 100-360, Sec. 211(c)(1)(A), (B), 
inserted ``(other than costs relating to the amendments made by the 
Medicare Catastrophic Coverage Act of 1988)'' before period at end of 
second sentence, and ``, but shall not take into account any amounts in 
the Trust Fund that may be attributable to receipts or outlays relating 
to the Medicare Catastrophic Coverage Account'' before period at end of 
last sentence.
    Subsec. (a)(2). Pub. L. 100-360, Sec. 211(c)(1)(C), substituted ``, 
(e), and (g)'' for ``and (e)''.
    Subsec. (a)(3). Pub. L. 100-360, Sec. 211(c)(1)(D), substituted 
``subsections (e) and (g)'' for ``subsection (e)'' in introductory 
provisions.
    Subsec. (a)(4). Pub. L. 100-360, Sec. 211(c)(1)(A), (B), inserted 
``(other than costs relating to the amendments made by the Medicare 
Catastrophic Coverage Act of 1988)'' before period at end of second 
sentence, and ``, but shall not take into account any amounts in the 
Trust Fund that may be attributable to receipts or outlays relating to 
the Medicare Catastrophic Coverage Account'' before period at end of 
last sentence.
    Subsec. (b). Pub. L. 100-360, Sec. 211(c)(1)(E), substituted 
``otherwise determined under this section (without regard to subsections 
(f) and (g)(6) of this section)'' for ``determined under subsection (a) 
or (e) of this section''.
    Subsec. (e)(1). Pub. L. 100-360, Sec. 211(c)(1)(F), inserted 
``except as provided in subsection (g) of this section,'' after 
``subsection (a) of this section''.
    Subsec. (f). Pub. L. 100-485, Sec. 608(d)(8)(B), substituted ``for 
that December below the amount of benefits payable to that individual 
for that November'' for ``for that January below the amount of benefits 
payable to that individual for that December''.
    Pub. L. 100-360, Sec. 211(b), amended subsec. (f) generally, 
substituting a single paragraph for former pars. (1) and (2).
    Subsec. (g). Pub. L. 100-360, Sec. 211(a), added subsec. (g) 
relating to adjustment in medicare part B premium.
    Subsec. (g)(1)(B)(iii)(I). Pub. L. 100-485, Sec. 608(d)(9)(A)(i), 
substituted ``year, over'' for ``year, and''.
    Subsec. (g)(1)(B)(iii)(II). Pub. L. 100-485, Sec. 608(d)(9)(A)(ii), 
substituted ``supplemental premium rate'' for ``supplemental rate''.
    Subsec. (g)(7)(A)(ii). Pub. L. 100-485, Sec. 608(d)(9)(A)(iii), 
substituted ``of each such year'' for ``of such year''.
    1987--Subsec. (e). Pub. L. 100-203, Sec. 4080(1), substituted 
``1990'' for ``1989'' wherever appearing.
    Subsec. (f)(1). Pub. L. 100-203, Sec. 4080(2), substituted ``1987, 
or 1988'' for ``or 1987''.
    Subsec. (f)(2). Pub. L. 100-203, Sec. 4080(3), substituted ``1988, 
or 1989'' for ``or 1988''.
    1986--Subsec. (b). Pub. L. 99-509, Sec. 9319(c)(4), inserted ``or 
months during which the individual has not attained the age of 65 and 
for which the individual can demonstrate that the individual was 
enrolled in a large group health plan as an active individual (as those 
terms are defined in section 1395y(b)(4)(B) of this title)'' at end of 
second sentence.
    Pub. L. 99-272, Sec. 9219(a)(1), substituted ``months during which 
the individual has attained the age of 65 and for which the individual 
can demonstrate that the individual was enrolled in a group health plan 
described in section 1395y(b)(3)(A)(iv) of this title'' for ``months in 
which the individual has met the conditions specified in clauses (i) and 
(iii) of section 1395y(b)(3)(A) of this title and can demonstrate that 
the individual was enrolled in a group health plan described in clause 
(iv) of such section''.
    Subsec. (e). Pub. L. 99-272, Sec. 9313(1), substituted ``1989'' for 
``1988'' wherever appearing.
    Subsec. (f)(1). Pub. L. 99-272, Sec. 9313(2), substituted ``, 1986, 
or 1987'' for ``or 1986''.
    Subsec. (f)(2). Pub. L. 99-272, Sec. 9313(3), substituted ``, 1987, 
or 1988'' for ``or 1987''.
    Subsec. (f)(2)(A). Pub. L. 99-509, Sec. 9001(c), amended subpar. (A) 
generally. Prior to amendment, subpar. (A) read as follows: ``the 
monthly premium amount determined under subsection (a)(2) of this 
section for that January reduced by the amount (if any) necessary to 
make the monthly benefits under section 402 or 423 of this title for 
that December after the deduction of the monthly premium (disregarding 
subsection (b) of this section) for that January at least equal to the 
monthly benefits under section 402 or 423 of this title for the 
preceding November after the deduction of the premium (disregarding 
subsection (b) of this section) for that individual for that December, 
or''.
    1984--Subsec. (b). Pub. L. 98-369, Sec. 2338(a), inserted provision 
that there shall not be taken into account months in which the 
individual has met conditions specified in clauses (i) and (iii) of 
section 1395y(b)(3)(A) of this title and can demonstrate that the 
individual was enrolled in a group health plan described in clause (iv) 
of such section by reason of the individual's (or the individual's 
spouse's) current employment.
    Subsec. (e). Pub. L. 98-369, Sec. 2302(a), substituted ``1988'' for 
``1986'' in pars. (1) and (2).
    Subsec. (f). Pub. L. 98-369, Sec. 2302(b), added subsec. (f).
    Subsec. (f)(2)(A). Pub. L. 98-617, Sec. 3(b)(4), substituted ``for 
that December after the deduction'' for ``for that January after the 
deduction'' and ``for that December'' for ``for that November''.
    1983--Subsec. (a). Pub. L. 98-21, Sec. 606(a)(1), added subsec. (a) 
and struck out former subsec. (a) which provided that monthly premium of 
each individual enrolled under this part for each month before 1968 
would be $3.
    Subsec. (b). Pub. L. 98-21, Sec. 606(a)(3)(A), substituted 
``subsection (a) or (e)'' for ``subsection (b), (c), or (g)''.
    Pub. L. 98-21, Sec. 606(a)(1), (2), redesignated subsec. (d) as (b), 
and struck out former subsec. (b) which provided for determination by 
Secretary of monthly premium for each individual enrolled under this 
part for each month after 1967 and before July 1, 1973.
    Subsec. (c). Pub. L. 98-21, Sec. 606(a)(1), (2), redesignated 
subsec. (e) as (c), and struck out former subsec. (c) which directed 
Secretary to determine during December of each year after 1972 the 
monthly actuarial rate for enrollees age 65 and over applicable to 
succeeding fiscal year (beginning July 1), provided for his 
determination of monthly premium for such period, and directed him to 
determine monthly actuarial rate for disabled enrollees under age 65.
    Subsec. (d). Pub. L. 98-21, Sec. 606(a)(3)(B), which directed that 
``purposes of subsection (b)'' be substituted for ``purposes of 
subsection (c)'' was executed by substituting ``purposes of subsection 
(b)'' for ``purposes of subsection (d)'', as the probable intent of 
Congress in view of previous substitution of ``subsection (d)'' for 
``subsection (c)'' by Pub. L. 92-603, Sec. 203(d)(2).
    Pub. L. 98-21, Sec. 606(a)(2), redesignated subsec. (f) as (d). 
Former subsec. (d) redesignated (b).
    Pub. L. 97-448 inserted reference to determination of monthly 
premium pursuant to subsec. (g) of this section.
    Subsec. (e). Pub. L. 98-21, Sec. 606(a)(2), redesignated subsec. (g) 
as (e). Former subsec. (e) redesignated (c).
    Subsec. (e)(1). Pub. L. 98-21, Sec. 606(a)(3)(C), substituted 
``(a)'' for ``(c)'', ``(a)(1)'' for ``(c)(1)'', ``December 1983'' for 
``June 1983'', and ``January 1986'' for ``July 1985''.
    Subsec. (e)(2). Pub. L. 98-21, Sec. 606(a)(3)(C)(i), (iii), 
substituted ``(a)(3)'' for ``(c)(3)'' and ``January 1986'' for ``July 
1985''.
    Subsecs. (f), (g). Pub. L. 98-21, Sec. 606(a)(2), redesignated 
subsecs. (f) and (g) as (d) and (e), respectively.
    1982--Subsec. (c)(2). Pub. L. 97-248, Sec. 124(a)(1), substituted 
``except as provided in subsections (d) and (g)'' for ``except as 
provided in subsection (d)''.
    Subsec. (c)(3). Pub. L. 97-248, Sec. 124(a)(2), inserted ``(except 
as otherwise provided in subsection (g) of this section)''.
    Subsec. (g). Pub. L. 97-248, Sec. 124(b), added subsec. (g).
    1981--Subsec. (d). Pub. L. 97-35 substituted ``the close of the 
enrollment period in which he reenrolled'' for ``the month after the 
month in which he reenrolled'' in cl. (2).
    1980--Subsec. (d). Pub. L. 96-499 substituted ``who reenrolls) (2) 
the months which elapsed between the date of termination of a previous 
coverage period and the month after the month in which he reenrolled'' 
for ``who enrolls for a second time) (2) the months which elapsed 
between the date of the termination of his first coverage period and the 
close of the enrollment period in which he enrolled for the second 
time''.
    1977--Subsec. (c)(3)(B). Pub. L. 95-216 substituted ``the monthly 
premium rate most recently promulgated by the Secretary under this 
paragraph, increased by a percentage determined as follows: The 
Secretary shall ascertain the primary insurance amount computed under 
section 415(a)(1) of this title, based upon average indexed monthly 
earnings of $900, that applied to individuals who became eligible for 
and entitled to old-age insurance benefits on May 1 of the year of the 
promulgation'' for ``the monthly premium rate most recently promulgated 
by the Secretary under this paragraph or, in the case of the 
determination made in December 1971, such rate promulgated under 
subsection (b)(2) of this section multiplied by the ratio of (i) the 
amount in column IV of the table which, by reason of the law in effect 
at the time the promulgation is made, will be in effect as of May 1 next 
following such determination appears (or is deemed to appear) in section 
415(a) of this title on the line which includes the figure `750' in 
column III of such table to (ii) the amount in column IV of the table 
which appeared (or was deemed to appear) in section 415(a) of this title 
on the line which included the figure `750' in column III as of May 1 of 
the year in which such determination is made'' and inserted ``He shall 
increase the monthly premium rate by the same percentage by which that 
primary insurance amount is increased when, by reason of the law in 
effect at the time the promulgation is made, it is so computed to apply 
to those individuals on the following May 1.''
    1975--Subsec. (c)(3). Pub. L. 94-182 substituted ``May 1'' for 
``June 1'' wherever appearing.
    1972--Subsec. (b)(1). Pub. L. 92-603, Sec. 203(a), inserted ``and 
before July 1, 1973'' following ``1967''.
    Subsec. (b)(2). Pub. L. 92-603, Sec. 203(b), substituted ``ending on 
or before December 31, 1971'' for ``thereafter''.
    Subsec. (c). Pub. L. 92-603, Sec. 203(c), added subsec. (c). Former 
subsec. (c) redesignated (d).
    Subsec. (d). Pub. L. 92-603, Secs. 201(c)(4), 203(c), (d)(1), 
redesignated former subsec. (c) as (d), inserted reference to subsec. 
(c) after reference to subsec. (b), inserted ``(in the same continuous 
period of eligibility)'' after ``for each full 12 months'', and inserted 
provisions relating to any increase in an individual's monthly premium 
under the first sentence of this subsection. Former subsec. (d) 
redesignated (e).
    Subsec. (e). Pub. L. 92-603, Sec. 203(c), redesignated former 
subsec. (d) as (e). Former subsec. (e) redesignated (f).
    Pub. L. 92-603, Sec. 201(c)(5), added subsec. (e).
    Subsec. (f). Pub. L. 92-603, Sec. 203(c), (d)(2), redesignated 
former subsec. (e) as (f) and substituted ``subsection (d)'' for 
``subsection (c)''.
    1968--Subsec. (b)(2). Pub. L. 90-248 required Secretary, during 
December of each year, beginning in 1968, to determine and announce 
amount (whether or not such amount was applicable for premiums for any 
prior month) of supplementary medical insurance premium for 12-month 
period beginning on July 1 of each following year, which premium is to 
be such that aggregate premiums will equal one-half estimated benefit 
and administrative expenses of supplementary medical insurance program 
for such 12-month period, and that at time of announcement of premium 
amount, Secretary must make public actuarial assumptions and bases used 
in deciding amount of premium.


                    Effective Date of 1997 Amendment

    Amendment by section 4581(a) of Pub. L. 105-33 applicable to 
involuntary terminations of coverage under a group health plan occurring 
on or after Aug. 5, 1997, see section 4581(c) of Pub. L. 105-33, set out 
as a note under section 1395p of this title.


                    Effective Date of 1994 Amendment

    Section 151(c)(3) of Pub. L. 103-432 provided that the amendment 
made by that section is effective as if included in the enactment of 
Pub. L. 103-66.


                    Effective Date of 1989 Amendments

    Amendment by section 6202(b)(4)(C) of Pub. L. 101-239 applicable to 
items and services furnished after Dec. 19, 1989, see section 6202(b)(5) 
of Pub. L. 101-239, set out as a note under section 162 of Title 26, 
Internal Revenue Code.
    Amendment by section 6202(c)(2) of Pub. L. 101-239 applicable to 
enrollments occurring after, and premiums for months after, second 
calendar quarter beginning after Dec. 19, 1989, see section 6202(c)(3) 
of Pub. L. 101-239, set out as a note under section 1395p of this title.
    Amendment by Pub. L. 101-234 effective Jan. 1, 1990, and applicable 
to premiums for months beginning after Dec. 31, 1989, see section 202(b) 
of Pub. L. 101-234, set out as a note under section 401 of this title.


                    Effective Date of 1988 Amendments

    Amendment by Pub. L. 100-485 effective as if included in the 
enactment of the Medicare Catastrophic Coverage Act of 1988, Pub. L. 
100-360, see section 608(g)(1) of Pub. L. 100-485, set out as a note 
under section 704 of this title.
    Section 211(d) of Pub. L. 100-360, which provided that the 
amendments made by section 211 of Pub. L. 100-360 [amending this section 
and sections 1395w and 1395mm of this title] applied (except as 
otherwise specified in such amendments) to monthly premiums for months 
beginning with January 1989, was repealed by Pub. L. 101-234, title II, 
Sec. 202(a), Dec. 13, 1989, 103 Stat. 1981.


                    Effective Date of 1986 Amendments

    Amendment by section 9001(c) of Pub. L. 99-509 applicable with 
respect to monthly premiums under this section for months after December 
1986, see section 9001(d)(3) of Pub. L. 99-509, set out as a note under 
section 415 of this title.
    Amendment by section 9319(c)(4) of Pub. L. 99-509 applicable to 
enrollments occurring on or after Jan. 1, 1987, see section 9319(f)(2) 
of Pub. L. 99-509 set out as a note under section 1395y of this title.
    Section 9219(a)(3)(A) of Pub. L. 99-272 provided that: ``The 
amendment made by paragraph (1) [amending this section] shall apply to 
months beginning with January 1983 for premiums for months beginning 
with the first month that begins more than 30 days after the date of the 
enactment of this Act [Apr. 7, 1986].''


                    Effective Date of 1984 Amendments

    Amendment by Pub. L. 98-617 effective as if originally included in 
the Deficit Reduction Act of 1984, Pub. L. 98-369, see section 3(c) of 
Pub. L. 98-617, set out as a note under section 1395f of this title.
    Section 2302(c) of Pub. L. 98-369 provided that: ``The amendments 
made by this section [amending this section] shall apply to premiums for 
months beginning with January 1986.''
    Section 2338(d)(1) of Pub. L. 98-369 provided that: ``The amendment 
made by subsection (a) [amending this section] shall apply to months 
beginning with January 1983 for premiums for months beginning with the 
first month which begins more than 30 days after the date of the 
enactment of this Act [July 18, 1984].''


          Effective Date of 1983 Amendments; Transitional Rule

    Section 606(c) of Pub. L. 98-21 provided that: ``The amendments made 
by this section [amending this section and sections 1395i-2, 1395v, 
1395w, and 1395mm of this title] shall apply to premiums for months 
beginning with January 1984, and for months after June 1983 and before 
January 1984--
        ``(1) the monthly premiums under part A and under part B of 
    title XVIII of the Social Security Act [parts A and B of this 
    subchapter] for individuals enrolled under each respective part 
    shall be the monthly premium under that part for the month of June 
    1983, and
        ``(2) the amount of the Government contributions under section 
    1844(a)(1) of such Act [section 1395w(a)(1) of this title] shall be 
    computed on the basis of the actuarially adequate rate which would 
    have been in effect under part B of title XVIII of such Act for such 
    months without regard to the amendments made by this section, but 
    using the amount of the premium in effect for the month of June 
    1983.''
    Amendment by Pub. L. 97-448 effective as if originally included as a 
part of this section as this section was amended by the Tax Equity and 
Fiscal Responsibility Act of 1982, Pub. L. 97-248, see section 309(c)(2) 
of Pub. L. 97-448, set out as a note under section 426-1 of this title.


                    Effective Date of 1981 Amendment

    Amendment by Pub. L. 97-35 not applicable to enrollments pursuant to 
written requests for enrollment filed before Oct. 1, 1981, see section 
2151(b) of Pub. L. 97-35, set out as a note under section 1395p of this 
title.


                    Effective Date of 1980 Amendment

    Amendment by Pub. L. 96-499 applicable to enrollments occurring on 
or after Apr. 1, 1981, see section 945(d) of Pub. L. 96-499, set out as 
a note under section 1395p of this title.


                    Effective Date of 1977 Amendment

    Amendment by Pub. L. 95-216 effective with respect to monthly 
benefits and lump-sum death payments for deaths occurring after December 
1978, see section 206 of Pub. L. 95-216, set out as a note under section 
402 of this title.


                    Effective Date of 1975 Amendment

    Section 104(b) of Pub. L. 94-182 provided that: ``The amendments 
made by subsection (a) [amending this section] shall apply with respect 
to determinations made under section 1839(c)(3) of the Social Security 
Act [subsec. (c)(3) of this section] after the date of the enactment of 
this Act [Dec. 31, 1975].''


                    Effective Date of 1968 Amendment

    Amendment by Pub. L. 90-248 effective Dec. 1, 1968, see section 
145(e) of Pub. L. 90-248, set out as a note under section 1395p of this 
title.


              Determination of Premium Amounts by Secretary

    Pub. L. 90-97, Sec. 2, Sept. 30, 1967, 81 Stat. 249, provided that: 
``Notwithstanding the provisions of section 1839(a) and (b) of the 
Social Security Act [subsecs. (a) and (b) of this section]--
        ``(1) the dollar amount applicable for premiums under part B of 
    title XVIII of such Act [this part] for each month before April 1968 
    shall be $3, and
        ``(2) the Secretary of Health, Education, and Welfare may 
    determine and promulgate such dollar amount for months after March 
    1968 and before January 1970 at any time on or before December 31, 
    1967.''


Persons Enrolling Before April 1, 1968, Who Did Not Enroll During Their 
                        Initial Enrollment Period

    Pub. L. 90-97, Sec. 3(b), Sept. 30, 1967, 81 Stat. 250, provided 
that: ``In the case of any individual who did not enroll in the 
insurance program established under part B of title XVIII of the Social 
Security Act [this part] in his initial enrollment period, but does so 
enroll before April 1, 1968, the enrollment period in which he so 
enrolls shall, for purposes of section 1839(c) of such Act [subsec. (c) 
of this section], be deemed to have closed on December 31, 1967.''

                  Section Referred to in Other Sections

    This section is referred to in sections 1395i-2, 1395p, 1395v, 
1395w, 1396u-3 of this title.
