C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 406—HOSPITAL INSURANCE ELIGIBILITY AND ENTITLEMENT › Subpart A—General Provisions

42 C.F.R. § 406.5

Basis of eligibility and entitlement

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(a) Hospital insurance without premiums. Hospital insurance is available to most individuals without payment of a premium if they:

(1) Are age 65 or over, or

(2) Have received social security or railroad retirement disability benefits for 25 months; or

(3) Have end-stage renal disease. Subpart B of this part explains the requirements such individuals must meet to obtain hospital insurance without premiums.

(b) Premium hospital insurance. Many individuals who are age 65 or over, but do not meet the requirements set forth in subpart B of this part, and certain individuals under age 65, may obtain the benefits by paying a premium. Section 406.20 of this part explains the requirements individuals must meet to obtain premium hospital insurance.

[48 FR 12536, Mar. 25, 1983, as amended at 50 FR 33033, Aug. 16, 1985; 56 FR 38078, Aug. 12, 1991]
Notes of Decisions
Cited in 5 cases, 1992–2014 · leading case: Johnson v. Kindred Healthcare, Inc.
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Johnson v. Kindred Healthcare, Inc. (2014) mass “, 42 C.F.R. § 406.5 (a) (2012) (“[Medicare h]ospital insurance is available to most individuals without payment of a premium if they .”
City of Gadsden v. Boman (2013) ala “1081; 42 C.F.R. § 406.5 , 406.6, 406.10.) This concept is generally referred to as premium-free Part A hospital insurance.”
Fields v. Sullivan (1992) vawd “42 C.F.R. §§ 406.5 (a)(2); 407.-10(a)(1); 407.”
Morales v. Intelsat Global Service Corp. (2012) dcd “1 See 42 C.F.R. § 406.5 (b). In practical terms, Defendants are refusing to pay costs that would normally be covered by Medicare Part A because Plaintiffs could receive Medicare Part A coverage by paying a monthly premium.”
Morales v. Intelsat Global Service Corp. (2012) dcd “See 42 C.F.R. § 406.5 (b). In practical terms, Defendants are refusing to pay costs that would normally be covered by Medicare Part A because Plaintiffs could receive Medicare Part A coverage by paying a monthly premium.”
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