§426a — Title 42 The Public Health and Welfare | U.S. Code

Summary

Lets people age 65 get hospital insurance if they meet certain rules. To qualify you must be 65 and either turned 65 before 1968 or have at least 3 quarters of coverage for every year after 1966 up to the year you turned 65. You must not already be entitled to hospital insurance or covered by railroad retirement hospital benefits. You must live in the United States and be a U.S. citizen or a lawful permanent resident who has lived in the U.S. without interruption for the five years before you apply. You must also apply in the way the Secretary requires. The rule does not apply if, when you first become eligible, you are a member of certain organizations, have been convicted of certain disqualifying crimes, or are (or were on February 16, 1965) enrolled in the Federal Employees Health Benefits program or could have been enrolled then under the program’s rules. Money can be appropriated to the Federal Hospital Insurance Trust Fund to pay benefits, extra administrative costs, and any lost interest that result from giving benefits under these rules.

Title 42, §426a

The Public Health and Welfare — Source: USLM XML via OLRC

(a)Anyone who—

(1)has attained the age of 65,

(2)(A)attained such age before 1968, or (B) has not less than 3 quarters of coverage (as defined in this subchapter or section 228e(l) of title 45), whenever acquired, for each calendar year elapsing after 1966 and before the year in which he attained such age,

(3)is not, and upon filing application for monthly insurance benefits under section 402 of this title would not be, entitled to hospital insurance benefits under section 426 of this title, and is not certifiable as a qualified railroad retirement beneficiary under section 228s–2 of title 45,

(4)is a resident of the United States (as defined in section 410(i) of this title), and is (A) a citizen of the United States or (B) an alien lawfully admitted for permanent residence who has resided in the United States (as so defined) continuously during the 5 years immediately preceding the month in which he files application under this section, and

(5)has filed an application under this section in such manner and in accordance with such other requirements as may be prescribed in regulations of the Secretary,

(b)The provisions of subsection (a) shall not apply to any individual who—

(1)is, at the beginning of the first month in which he meets the requirements of subsection (a), a member of any organization referred to in section 410(a)(17) 11 See References in Text note below. of this title,

(2)has, prior to the beginning of such first month, been convicted of any offense listed in section 402(u) of this title, or

(3)(A)at the beginning of such first month is covered by an enrollment in a health benefits plan under chapter 89 of title 5,

(B)was so covered on February 16, 1965, or

(C)could have been so covered for such first month if he or some other person had availed himself of opportunities to enroll in a health benefits plan under such chapter and to continue such enrollment (but this subparagraph shall not apply unless he or such other person was a Federal employee at any time after February 15, 1965).

(c)There are authorized to be appropriated to the Federal Hospital Insurance Trust Fund (established by section 1395i of this title) from time to time such sums as the Secretary deems necessary for any fiscal year, on account of—

(1)payments made or to be made during such fiscal year from such Trust Fund under part A of subchapter XVIII of this chapter with respect to individuals who are entitled to hospital insurance benefits under section 426 of this title solely by reason of this section,

(2)the additional administrative expenses resulting or expected to result therefrom, and

(3)any loss in interest to such Trust Fund resulting from the payment of such amounts,

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 228e(l) and 228s–2 of title 45, referred to in subsec. (a)(2), (3), are references to section 5(l) and 21 of the Railroad Retirement Act of 1937. That Act was amended in its entirety and completely revised by Pub. L. 93–445, Oct. 16, 1974, 88 Stat. 1305. That Act, as thus amended and revised, was redesignated the Railroad Retirement Act of 1974, and is classified generally to subchapter IV (§ 231 et seq.) of chapter 9 of Title 45, Railroads. section 228e and 228s–2 of title 45 are covered by section 231e and 231f of Title 45, respectively. section 410(a)(17) of this title, referred to in subsec. (b)(1), was repealed by Pub. L. 113–295, div. A, title II, § 221(a)(99)(C)(ii), Dec. 19, 2014, 128 Stat. 4052. Codification Section was not enacted as part of the Social Security Act which comprises this chapter.

Amendments

1968—Subsec. (a)(2)(B). Pub. L. 90–248, § 139, substituted “1966” for “1965”. Subsec. (b)(3)(A), (C). Pub. L. 90–248, § 403(h)(1), (2), substituted “chapter 89 of title 5” and “such chapter” for “the Federal Employees Health Benefits Act of 1959” and “such Act” in subpars. (A) and (C), respectively.

§426a Transitional provision on eligibility of uninsured individuals for hospital insurance benefits