
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)[115(a)]]
[Document affected by Public Law 106-554 Section 1(a)(6)[115(c)]]
[CITE: 42USC426]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
  SUBCHAPTER II--FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE 
                                BENEFITS
 
Sec. 426. Entitlement to hospital insurance benefits


(a) Individuals over 65 years

    Every individual who--
        (1) has attained age 65, and
        (2)(A) is entitled to monthly insurance benefits under section 
    402 of this title, 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 of this chapter,
        (B) is a qualified railroad retirement beneficiary, or
        (C)(i) would meet the requirements of subparagraph (A) upon 
    filing application for the monthly insurance benefits involved if 
    medicare qualified government employment (as defined in section 
    410(p) of this title) were treated as employment (as defined in 
    section 410(a) of this title) 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 of this chapter,

shall be entitled to hospital insurance benefits under part A of 
subchapter XVIII of this chapter 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) is entitled to, and has for 24 calendar months been 
    entitled to, (i) disability insurance benefits under section 423 of 
    this title or (ii) child's insurance benefits under section 402(d) 
    of this title by reason of a disability (as defined in section 
    423(d) of this title) or (iii) widow's insurance benefits under 
    section 402(e) of this title or widower's insurance benefits under 
    section 402(f) of this title by reason of a disability (as defined 
    in section 423(d) of this title), or
        (B) is, and has been for not less than 24 months, a disabled 
    qualified railroad retirement beneficiary, within the meaning of 
    section 231f(d) of title 45, or
        (C)(i) has filed an application, in conformity with regulations 
    of the Secretary, for hospital insurance benefits under part A of 
    subchapter XVIII of this chapter 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) medicare qualified government employment (as defined in 
        section 410(p) of this title) were treated as employment (as 
        defined in section 410(a) of this title) 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),

shall be entitled to hospital insurance benefits under part A of 
subchapter XVIII of this chapter 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 section 422(c)(4)(A) of this title, 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 section 423(a)(1) of this title, in 
section 402(d)(1)(G)(i) of this title, in the last sentence of section 
402(e)(1) of this title, and in the last sentence of section 402(f)(1) 
of this title shall be applied as though it read ``15 months''.

(c) Conditions

    For purposes of subsection (a) of this section--
        (1) 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 of 
    this chapter on his behalf for inpatient hospital services, post-
    hospital extended care services, and home health services (as such 
    terms are defined in part D of subchapter XVIII of this chapter) 
    furnished him in the United States (or outside the United States in 
    the case of inpatient hospital services furnished under the 
    conditions described in section 1395f(f) of this title) 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 of this 
    chapter occurred (i) after June 30, 1966, 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) of this section, at a time when he was so entitled; 
    and
        (2) an individual shall be deemed entitled to monthly insurance 
    benefits under section 402 or section 423 of this title, 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

    For 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 
section 231f(d) of title 45. 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 section 231f(d) of title 
45.

(e) Benefits for widows and widowers

    (1)(A) For purposes of determining entitlement to hospital insurance 
benefits under subsection (b) of this section 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)(5) of this title shall be deemed to 
    read ``age 65''; and
        (ii) the phrase ``before she attained age 60'' in the matter 
    following subparagraph (F) of section 402(e)(1) of this title and 
    the phrase ``before he attained age 60'' in the matter following 
    subparagraph (F) of section 402(f)(1) of this title shall each be 
    deemed to read ``based on a disability''.

    (B) For purposes of subsection (b)(2)(A)(iii) of this section, 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 of this chapter, or State supplementary payments of 
the type referred to in section 1382e(a) of this title (or payments of 
the type described in section 212(a) of Public Law 93-66) which are paid 
by the Secretary under an agreement referred to in section 1382e(a) of 
this title (or in section 212(b) of Public Law 93-66), 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) For purposes of determining entitlement to hospital insurance 
benefits under subsection (b) of this section in the case of an 
individual under age 65 who is entitled to benefits under section 402 of 
this title, 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) of this section, 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) For purposes of determining entitlement to hospital insurance 
benefits under subsection (b) of this section in the case of an 
individual described in clause (iii) of subsection (b)(2)(A) of this 
section, 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 section 402(j)(4) of this title.

(f) Medicare waiting period for recipients of disability benefits

    For purposes of subsection (b) of this section (and for purposes of 
section 1395p(g)(1) of this title and section 231f(d)(2)(ii) of title 
45), 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 section 1395p(f) of this title), 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) of this 
    section, 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

    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 section 410(a)(5) of this title 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 of this chapter, (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) of 
this section, giving particular attention to individuals who apply for 
an annuity under chapter 83 \1\ 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.
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    \1\ So in original. Probably should be ``subchapter III of chapter 
83''.
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(h) Certain uninsured individuals

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

(i) Continuing eligibility of certain terminated individuals

    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 section 425(c) \2\ of this title 
shall be treated as entitled to such benefit for such month.
---------------------------------------------------------------------------
    \2\ See References in Text note below.
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(Aug. 14, 1935, ch. 531, title II, Sec. 226, as added Pub. L. 89-97, 
title I, Sec. 101, July 30, 1965, 79 Stat. 290; amended Pub. L. 90-248, 
title I, Sec. 129(c)(1), Jan. 2, 1968, 81 Stat. 847; Pub. L. 92-603, 
title II, Secs. 201(b), 299I, Oct. 30, 1972, 86 Stat. 1371, 1463; Pub. 
L. 93-58, Sec. 3, July 6, 1973, 87 Stat. 142; Pub. L. 93-233, 
Sec. 18(f), Dec. 31, 1973, 87 Stat. 969; Pub. L. 93-445, title III, 
Sec. 305, Oct. 16, 1974, 88 Stat. 1358; Pub. L. 95-216, title III, 
Secs. 332(a)(3), 334(d)(4)(B), Dec. 20, 1977, 91 Stat. 1543, 1546; Pub. 
L. 95-292, Secs. 1(b), 3, June 13, 1978, 92 Stat. 308, 315; Pub. L. 96-
265, title I, Secs. 103(a)(1), (b), 104(a), June 9, 1980, 94 Stat. 444; 
Pub. L. 96-473, Sec. 2(a), Oct. 19, 1980, 94 Stat. 2263; Pub. L. 96-499, 
title IX, Sec. 930(q), Dec. 5, 1980, 94 Stat. 2633; Pub. L. 97-35, title 
XXII, Sec. 2203(e), Aug. 13, 1981, 95 Stat. 837; Pub. L. 97-248, title 
II, Sec. 278(b)(2)(A), (B), (4), Sept. 3, 1982, 96 Stat. 560, 561; Pub. 
L. 98-21, title I, Sec. 131(a)(3)(H), (b)(3)(G), title III, 
Sec. 309(q)(1), Apr. 20, 1983, 97 Stat. 93, 117; Pub. L. 98-369, div. B, 
title VI, Sec. 2663(a)(17), July 18, 1984, 98 Stat. 1165; Pub. L. 99-
272, title XIII, Sec. 13205(b)(2)(A), (C)(ii), Apr. 7, 1986, 100 Stat. 
317; Pub. L. 100-203, title IV, Sec. 4033(a), formerly Sec. 4033(a)(1), 
title IX, Sec. 9010(e)(3), Dec. 22, 1987, 101 Stat. 1330-77, 1330-294, 
renumbered Pub. L. 100-360, title IV, Sec. 411(e)(2), July 1, 1988, 102 
Stat. 775; Pub. L. 100-360, title IV, Sec. 411(n)(1), July 1, 1988, 102 
Stat. 807; Pub. L. 100-485, title VI, Sec. 608(f)(5), Oct. 13, 1988, 102 
Stat. 2424; Pub. L. 101-508, title V, Sec. 5103(c)(2)(C), Nov. 5, 1990, 
104 Stat. 1388-252; Pub. L. 103-296, title II, Sec. 201(a)(3)(D)(i), 
Aug. 15, 1994, 108 Stat. 1497; Pub. L. 105-33, title IV, 
Sec. 4002(f)(1), Aug. 5, 1997, 111 Stat. 329; Pub. L. 106-170, title II, 
Sec. 202(a), Dec. 17, 1999, 113 Stat. 1894.)

                       References in Text

    Parts A and D of subchapter XVIII of this chapter, referred to in 
text, are classified to section 1395c et seq. and 1395x et seq., 
respectively, of this title.
    Section 212 of Public Law 93-66, referred to in subsec. (e)(1)(B), 
is section 212 of Pub. L. 93-66 which is set out as a note under section 
1382 of this title.
    Section 425(c) of this title, referred to in subsec. (i), was 
repealed by Pub. L. 104-121, title I, Sec. 105(a)(4), Mar. 29, 1996, 110 
Stat. 853.


                               Amendments

    1999--Subsec. (b). Pub. L. 106-170 substituted ``78'' for ``24'' in 
penultimate sentence.
    1997--Subsec. (c)(1). Pub. L. 105-33 substituted ``part D'' for 
``part C''.
    1994--Subsec. (i). Pub. L. 103-296 added subsec. (i).
    1990--Subsec. (e)(1). Pub. L. 101-508 designated existing provisions 
as subpar. (A), redesignated former subpars. (A) and (B) as cls. (i) and 
(ii), respectively, and added subpar. (B).
    1988--Subsec. (a). Pub. L. 100-485 substituted ``condition specified 
in paragraph (2)'' for ``condition specified in paragraph (1)'' in 
concluding provisions.
    Subsec. (b). Pub. L. 100-360, Sec. 411(n)(1), 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 section 
423(a) of this title shall be applied as though the term `36 months' (in 
such second sentence) read `15 months'.''
    1987--Subsec. (b). Pub. L. 100-203, Sec. 9010(e)(3), inserted 
sentence at end which related to determining when an individual's 
entitlement or status terminates for purposes of preceding sentence.
    Subsec. (f). Pub. L. 100-203, Sec. 4033(a), 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''.
    1986--Subsec. (a)(2)(C)(i). Pub. L. 99-272, Sec. 13205(b)(2)(A) 
substituted ``medicare qualified government employment'' for ``medicare 
qualified Federal employment''.
    Subsec. (b)(2)(C)(ii)(I). Pub. L. 99-272, Sec. 13205(b)(2)(A), 
substituted ``medicare qualified government employment'' for ``medicare 
qualified Federal employment''.
    Subsec. (g). Pub. L. 99-272, Sec. 13205(b)(2)(C)(ii), substituted 
``medicare qualified government employment by virtue of service 
described in section 410(a)(5) of this title'' for ``medicare qualified 
Federal employment''.
    1984--Subsec. (b). Pub. L. 98-369 substituted ``part A'' for ``part 
(A)'' in provisions following par. (2)(C).
    1983--Subsec. (e)(1)(A). Pub. L. 98-21, Sec. 131(a)(3)(H), 
(b)(3)(G), substituted reference to section 402(e)(4), (f)(5) of this 
title for reference to section 405(e)(5), (f)(6) of this title.
    Subsec. (e)(3). Pub. L. 98-21, Sec. 309(q)(1), 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 July 1, 1974, 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.
    1982--Subsec. (a)(2). Pub. L. 97-248, Sec. 278(b)(2)(A), 
redesignated existing provisions as subpar. (A), struck out ``or is a 
qualified railroad retirement beneficiary,'' after ``of this chapter,'', 
and added subpars. (B) and (C).
    Subsec. (b). Pub. L. 97-248, Sec. 278(b)(2)(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).
    Subsecs. (g), (h). Pub. L. 97-248, Sec. 278(b)(4), added subsec. (g) 
and redesignated former subsec. (g) as (h).
    1981--Subsec. (a)(2). Pub. L. 97-35 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,''.
    1980--Subsec. (a)(2). Pub. L. 96-473 inserted provisions relating to 
persons who would be entitled to benefits but for enumerated exceptions.
    Subsec. (b). Pub. L. 96-265, Sec. 104(a), 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 section 422(c)(4)(A) of this title, 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, Sec. 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''.
    Subsec. (c)(1). Pub. L. 96-499 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''.
    Subsecs. (f), (g). Pub. L. 96-265, Sec. 103(b), added subsec. (f) 
and redesignated former subsec. (f) as (g).
    1978--Subsec. (a). Pub. L. 95-292, Sec. 3(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)''.
    Subsec. (e). Pub. L. 95-292, Secs. 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 Pub. L. 93-233 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 section 426-1 of this title.
    Subsec. (f). Pub. L. 95-292, Sec. 1(b)(1), (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 
section 426-1 of this title.
    Subsec. (g). Pub. L. 95-292, Sec. 1(b)(1), struck out subsec. (g) 
which related to reimbursement for kidney transplant and kidney 
treatment. See section 1395rr of this title.
    Subsecs. (h), (i). Pub. L. 95-292, Sec. 1(b)(2), redesignated 
subsecs. (h) and (i) as (e) and (f), respectively.
    1977--Subsec. (h)(1)(B). Pub. L. 95-216, Sec. 334(d)(4)(B), 
substituted ``subparagraph (F) of section 402(f)(1)'' for ``subparagraph 
(G) of section 402(f)(1)''.
    Subsec. (h)(4). Pub. L. 95-216, Sec. 332(a)(3), added par. (4).
    1974--Subsec. (b)(2). Pub. L. 93-445, Sec. 305(a), substituted 
``section 7(d) of the Railroad Retirement Act of 1974'' for ``section 22 
of the Railroad Retirement Act of 1937''.
    Subsec. (d). Pub. L. 93-445, Sec. 305(b), 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.
    Subsec. (e). Pub. L. 93-445, Sec. 305(c), substituted ``Railroad 
Retirement Act of 1974'' for ``Railroad Retirement Act of 1937'', 
wherever appearing.
    1973--Subsec. (a). Pub. L. 93-233, Sec. 18(f)(1)(A), redesignated 
subsec. (a)(1) as subsec. (a).
    Subsec. (a)(1), (2). Pub. L. 93-233, Sec. 18(f)(1)(B), redesignated 
cls. (A) and (B) as (1) and (2), respectively.
    Subsec. (e)(2). Pub. L. 93-58, 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 December 31, 1936, were 
included in the term `employment' as defined in this chapter'' after 
``(as such terms are defined in section 414 of this title)''; 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 December 31, 1936, 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''.
    Subsec. (h). Pub. L. 93-233, Sec. 18(f)(1)(C), (2)-(4), redesignated 
as subsec. (h) provisions originally enacted as subsec. (e) by section 
201(b)(5) of Pub. L. 92-603 and redesignated as subsec. (f) by section 
299I of Pub. L. 92-603, 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 section 402(f)(1) of this 
title shall each'' for ``shall'', and in pars. (2) and (3) substituted 
``(b)'' for ``(a)(2)'', respectively.
    Subsec. (i). Pub. L. 93-233, Sec. 18(f)(1)(C), redesignated as 
subsec. (i) provisions originally enacted as subsec. (d) by section 101 
of Pub. L. 89-97 and redesignated as subsec. (f) by section 201(b)(5) of 
Pub. L. 92-603.
    1972--Subsec. (a). Pub. L. 92-603, Sec. 201(b)(1), incorporated 
provisions of former subsec. (a) and subsec. (a)(1), and redesignated 
pars. (1) and (2) as subpars. (A) and (B).
    Subsec. (b). Pub. L. 92-603, Sec. 201(b)(1), added subsec. (b). 
Former subsec. (b) redesignated subsec. (c).
    Subsec. (c)(1). Pub. L. 92-603, Sec. 201(b)(2), (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).
    Subsec. (c)(2). Pub. L. 92-603, Sec. 201(b)(3), (5), redesignated 
subsec. (b)(2) as subsec. (c)(2) and inserted reference to section 423 
of this title. Former subsec. (c) redesignated subsec. (d).
    Subsec. (d). Pub. L. 92-603, Sec. 201(b)(4), (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).
    Subsecs. (e) to (h). Pub. L. 92-603, Secs. 201(b)(5), 299I, added 
subsecs. (e) to (h). See 1973 Amendment note above.
    Subsec. (i). Pub. L. 92-603, Sec. 201(b)(5), redesignated former 
subsec. (d) as subsec. (i). See 1973 Amendment note above.
    1968--Subsec. (b)(1). Pub. L. 90-248 struck out outpatient hospital 
diagnostic services from services for which hospital insurance benefits 
are payable.


                    Effective Date of 1999 Amendment

    Pub. L. 106-170, title II, Sec. 202(b), Dec. 17, 1999, 113 Stat. 
1894, provided that: ``The amendment made by subsection (a) [amending 
this section] shall be effective on and after October 1, 2000.''


                    Effective Date of 1994 Amendment

    Amendment by Pub. L. 103-296 applicable with respect to benefits 
based on disability (as defined in section 425(c)(9) of this title) 
which are otherwise payable in months beginning after 180 days after 
Aug. 15, 1994, with Secretary of Health and Human Services to issue 
regulations necessary to carry out such amendment not later than 180 
days after Aug. 15, 1994, see section 201(a)(3)(E)(i) of Pub. L. 103-
296, set out as an Effective Date of 1994 Amendment; Sunset Provision 
note under section 425 of this title.


                    Effective Date of 1990 Amendment

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


                    Effective Date of 1988 Amendments

    Section 608(f)(5) of Pub. L. 100-485 provided that the amendment 
made by such section 608(f)(5) is effective as of the date of enactment 
of Pub. L. 95-292, which was approved June 13, 1978.
    Except as specifically provided in section 411 of Pub. L. 100-360, 
amendment by Pub. L. 100-360, as it relates to a provision in the 
Omnibus Budget Reconciliation Act of 1987, Pub. L. 100-203, effective as 
if included in the enactment of that provision in Pub. L. 100-203, see 
section 411(a) of Pub. L. 100-360, set out as a Reference to OBRA; 
Effective Date note under section 106 of Title 1, General Provisions.


                    Effective Date of 1987 Amendment

    Section 4033(b), formerly section 4033(a)(2) of Pub. L. 100-203, as 
renumbered by Pub. L. 100-360, title IV, Sec. 411(e)(2), July 1, 1988, 
102 Stat. 775, provided that:
        ``(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 [Dec. 22, 
    1987].
        ``(2) 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 [subsec. (f) of this section]) 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).''
    Amendment by section 9010(e)(3) of Pub. L. 100-203 effective Jan. 1, 
1988, 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 section 9010 of Pub. L. 
100-203 has not elapsed as of Jan. 1, 1988, see section 9010(f) of Pub. 
L. 100-203, set out as a note under section 402 of this title.


                    Effective Date of 1986 Amendment

    Amendment by Pub. L. 99-272 effective after Mar. 31, 1986, with no 
individual to be considered under disability for any period beginning 
before Apr. 1, 1986, for purposes of hospital insurance benefits, see 
section 13205(d)(2) of Pub. L. 99-272, set out as a note under section 
410 of this title.


                    Effective Date of 1984 Amendment

    Amendment by Pub. L. 98-369 effective July 18, 1984, 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 section 2664(b) of Pub. L. 98-369, set out as a 
note under section 401 of this title.


                    Effective Date of 1983 Amendments

    Amendment by section 131(a)(3)(H), (b)(3)(G) of Pub. L. 98-21 
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 section 131(d) of Pub. L. 98-21 set out as a 
note under section 402 of this title.
    Amendment by section 309(q)(1) of Pub. L. 98-21 applicable only with 
respect to monthly payments payable under this subchapter for months 
after April 1983, see section 310 of Pub. L. 98-21, set out as a note 
under section 402 of this title.
    Pub. L. 97-448, title III, Sec. 309(c)(1), Jan. 12, 1983, 96 Stat. 
2410, provided that: ``Any amendment to the Tax Equity and Fiscal 
Responsibility Act of 1982 [Pub. L. 97-248, Sept. 3, 1982, 96 Stat. 324] 
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 1396o of this 
title] shall be effective as if it had been originally included in the 
provision of such Act to which such amendment relates.''


        Effective Date of 1982 Amendment; Transitional Provisions

    Section 278(c)(2), (d) of Pub. L. 97-248, as amended by Pub. L. 97-
448, title III, Sec. 309(a)(10), (11), Jan. 12, 1983, 96 Stat. 2408, 
provided that:
    ``(c) Effective Dates.--
        ``(2) Medicare coverage.--
            ``(A) In general.--The amendments made by subsection (b) 
        [amending this section and sections 410, 426-1, and 1395c of 
        this title] are effective on and after January 1, 1983, and the 
        amendments made by paragraph (2) of that subsection [amending 
        this section and section 426-1 of this title] apply to 
        remuneration (for medicare qualified Federal employment) paid 
        after December 31, 1982.
            ``(B) Treatment of current disabilities.--For purposes of 
        establishing entitlement to hospital insurance benefits under 
        part A of title XVIII of the Social Security Act [section 1395c 
        et seq. of this title] 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 January 1, 1983.
    ``(d) Transitional Provisions.--
        ``(1) In general.--For purposes of sections 226, 226A, and 1811 
    of the Social Security Act [this section and sections 426-1 and 
    1395c of this title], in the case of any individual who performs 
    service both during January 1983, and before January 1, 1983, which 
    constitutes medicare qualified Federal employment (as defined in 
    section 210(p) of such Act [section 410(p) of this title]), the 
    individual's medicare qualified Federal employment (as so defined) 
    performed before January 1, 1983, for which remuneration was paid 
    before such date, shall be considered to be `employment' (as defined 
    for purposes of title II of such Act [this subchapter]), 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 [section 1395c et seq. of this title].
        ``(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) 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 [section 1395 et seq. of this title] 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.''


                    Effective Date of 1981 Amendment

    Section 2203(f)(3) of Pub. L. 97-35, as amended by Pub. L. 97-248, 
title I, Sec. 128(c)(2), Sept. 3, 1982, 96 Stat. 367, provided that: 
``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.''


                    Effective Date of 1980 Amendments

    Amendment by Pub. L. 96-499 effective with respect to services 
furnished on or after July 1, 1981, see section 930(s)(1) of Pub. L. 96-
499, set out as a note under section 1395x of this title.
    Section 2(d) of Pub. L. 96-473 provided that: ``The amendments made 
by subsections (a) and (b) [amending this section and section 1395c of 
this title] shall be effective after the second month beginning after 
the date on which this Act is enacted [Oct. 19, 1980].''
    Section 103(c) of Pub. L. 96-265 provided that: ``The amendments 
made by this section [amending this section and sections 1395c and 1395p 
of this title and section 231f of Title 45, 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 [June 9, 
1980].''
    Section 104(b) of Pub. L. 96-265 provided that: ``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 [June 9, 1980], and shall apply with respect to 
any individual whose disability has not been determined to have ceased 
prior to such first day.''


                    Effective Date of 1978 Amendment

    Section 6 of Pub. L. 95-292 provided that: ``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, 
1395l, 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 [June 13, 1978], 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 April 1, 1979.''


                    Effective Date of 1977 Amendment

    Amendment by section 332(a)(3) of Pub. L. 95-216 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 Jan. 1, 1978, see section 332(b) of Pub. L. 95-216, set out as a 
note under section 402 of this title.
    Amendment by section 334(d)(4)(B) of Pub. L. 95-216 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 section 334(f) of Pub. L. 95-216, set out 
as a note under section 402 of this title.


                    Effective Date of 1974 Amendment

    Amendment by Pub. L. 93-445 effective Jan. 1, 1975, see section 603 
of Pub. L. 93-445, set out as a note under section 402 of this title.


                    Effective Date of 1973 Amendment

    Section 4(a) of Pub. L. 93-58 provided that: ``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 Public Law 92-603 are effective 
as follows: clause (xi) [section 228c(e)(xi) of Title 45] effective with 
respect to services provided on and after July 1, 1973. The provisions 
of clauses (xi) and (xii), which are added by section 1 of this Act, 
shall be effective as follows: clause (xi) [section 228c(e)(xi) of Title 
45] shall be effective with respect to calendar years after 1971 for 
annuities accruing after December 1972; and clause (xii) [section 
228c(e)(xii) of Title 45 shall be effective as of the date the delayed 
retirement provision of Public Law 92-603 is effective [section 402(w) 
of this title applicable with respect to old-age insurance benefits 
payable under this subchapter for months beginning after 1972].''


                    Effective Date of 1972 Amendment

    Section 299I of Pub. L. 92-603 provided that the amendment made by 
that section is effective with respect to services provided on and after 
July 1, 1973.


                    Effective Date of 1968 Amendment

    Amendment by Pub. L. 90-248 applicable with respect to services 
furnished after March 31, 1968, see section 129(d) of Pub. L. 90-248, 
set out as a note under section 1395d of this title.


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

    Section 2(c) of Pub. L. 96-473 provided that: ``For purposes of 
section 226 of such Act [this section] as amended by subsection (a) of 
this section, an individual who filed an application for monthly 
insurance benefits under section 202 of such Act [section 402 of this 
title] prior to the effective date of the amendment made by subsection 
(a) [see section 2(c) of Pub. L. 96-473, 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 [part A of subchapter XVIII of this chapter] 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.''


                               GAO Report

    Pub. L. 106-170, title II, Sec. 202(c), Dec. 17, 1999, 113 Stat. 
1894, provided that: ``Not later than 5 years after the date of the 
enactment of this Act [Dec. 17, 1999], 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) examines the necessity and effectiveness of providing 
    continuation of medicare coverage under section 226(b) of the Social 
    Security Act (42 U.S.C. 426(b)) to individuals whose annual income 
    exceeds the contribution and benefit base (as determined under 
    section 230 of such Act (42 U.S.C. 430));
        ``(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.''


   Time in Which To Furnish Proof of Disability for Hospital Benefits

    Section 309(q)(2) of Pub. L. 98-21 provided that: ``For purposes of 
determining entitlement to hospital insurance benefits under section 
226(e)(3) of such Act [subsec. (e)(3) of this section], 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.''


           Special $50 Payment Under Tax Reduction Act of 1975

    Special payment of $50 as soon as practicable after Mar. 29, 1975, 
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 section 702 of Pub. L. 94-12, set out as a note 
under section 402 of this title.


                 Adopted Child's Reenlistment to Annuity

    Section 4(b) of Pub. L. 93-58 provided that: ``Any child (1) whose 
entitlement to an annuity under section 5(c) of the Railroad Retirement 
Act [section 228e(c) of Title 45, Railroads] was terminated by reason of 
his adoption prior to the enactment of this Act [July 6, 1973], 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 [section 228a et seq. of Title 45] after the 
date of enactment of this Act [July 6, 1973], 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(l)(1)(ii) of the 
Railroad Retirement Act [section 228e(l)(1)(ii)].''

                  Section Referred to in Other Sections

    This section is referred to in sections 401, 410, 418, 426-1, 426a, 
433, 434, 1320b-1, 1395c, 1395f, 1395h, 1395i-1, 1395i-2, 1395i-2a, 
1395p, 1395u, 1395y, 1395ff, 1395ss of this title; title 10 section 
1086; title 45 sections 231f, 231r.
