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U.S. Code as of:
01/19/04
Section 1395i-2a. Hospital insurance benefits for disabled individuals who have exhausted other entitlement
(a) Eligibility
Every individual who -
(1) has not attained the age of 65;
(2)(A) has been entitled to benefits under this part under
section 426(b) of this title, and
(B)(i) continues to have the disabling physical or mental
impairment on the basis of which the individual was found to be
under a disability or to be a disabled qualified railroad
retirement beneficiary, or (ii) is blind (within the meaning of
section 416(i)(1) of this title), but
(C) whose entitlement under section 426(b) of this title ends
due solely to the individual having earnings that exceed the
substantial gainful activity amount (as defined in section
423(d)(4) of this title); and
(3) is not otherwise entitled to benefits under this part,
shall be eligible to enroll in the insurance program established by
this part.
(b) Enrollment
(1) An individual may enroll under this section only in such
manner and form as may be prescribed in regulations, and only
during an enrollment period prescribed in or under this section.
(2) The individual's initial enrollment period shall begin with
the month in which the individual receives notice that the
individual's entitlement to benefits under section 426(b) of this
title will end due solely to the individual having earnings that
exceed the substantial gainful activity amount (as defined in
section 423(d)(4) of this title and shall end 7 months later.
(3) There shall be a general enrollment period during the period
beginning on January 1 and ending on March 31 of each year
(beginning with 1990).
(c) Coverage period
(1) The period (in this subsection referred to as a "coverage
period") during which an individual is entitled to benefits under
the insurance program under this part shall begin on whichever of
the following is the latest:
(A) In the case of an individual who enrolls under subsection
(b)(2) of this section before the month in which the individual
first satisfies subsection (a) of this section, the first day of
such month.
(B) In the case of an individual who enrolls under subsection
(b)(2) of this section in the month in which the individual first
satisfies subsection (a) of this section, the first day of the
month following the month in which the individual so enrolls.
(C) In the case of an individual who enrolls under subsection
(b)(2) of this section in the month following the month in which
the individual first satisfies subsection (a) of this section,
the first day of the second month following the month in which
the individual so enrolls.
(D) In the case of an individual who enrolls under subsection
(b)(2) of this section more than one month following the month in
which the individual first satisfies subsection (a) of this
section, the first day of the third month following the month in
which the individual so enrolls.
(E) In the case of an individual who enrolls under subsection
(b)(3) of this section, the July 1 following the month in which
the individual so enrolls.
(2) An individual's coverage period under this section shall
continue until the individual's enrollment is terminated as
follows:
(A) As of the month following the month in which the Secretary
provides notice to the individual that the individual no longer
meets the condition described in subsection (a)(2)(B) of this
section.
(B) As of the month following the month in which the individual
files notice that the individual no longer wishes to participate
in the insurance program established by this part.
(C) As of the month before the first month in which the
individual becomes eligible for hospital insurance benefits under
section 426(a) or 426-1 of this title.
(D) As of a date, determined under regulations of the
Secretary, for nonpayment of premiums.
The regulations under subparagraph (D) may provide a grace period
of not longer than 90 days, which may be extended to not to exceed
180 days in any case where the Secretary determines that there was
good cause for failure to pay the overdue premiums within such
90-day period. Termination of coverage under this section shall
result in simultaneous termination of any coverage affected under
any other part of this subchapter.
(3) The provisions of subsections (h) and (i) of section 1395p of
this title apply to enrollment and nonenrollment under this section
in the same manner as they apply to enrollment and nonenrollment
and special enrollment periods under section 1395i-2 of this title.
(d) Payment of premiums
(1)(A) Premiums for enrollment under this section shall be paid
to the Secretary at such times, and in such manner, as the
Secretary shall by regulations prescribe, and shall be deposited in
the Treasury to the credit of the Federal Hospital Insurance Trust
Fund.
(B)(i) Subject to clause (ii), such premiums shall be payable for
the period commencing with the first month of an individual's
coverage period and ending with the month in which the individual
dies or, if earlier, in which the individual's coverage period
terminates.
(ii) Such premiums shall not be payable for any month in which
the individual is eligible for benefits under this part pursuant to
section 426(b) of this title.
(2) The provisions of subsections (d) through (f) of section
1395i-2 of this title (relating to premiums) shall apply to
individuals enrolled under this section in the same manner as they
apply to individuals enrolled under that section.
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