U.S. Code » Title 42 » Chapter CHAPTER 7— SOCIAL SECURITY › Subchapter SUBCHAPTER XVIII— HEALTH INSURANCE FOR AGED AND DISABLED › Part Part A— Hospital Insurance Benefits for Aged and Disabled

42 U.S.C. § 1395c

Description of program

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The insurance program for which entitlement is established by sections 426 and 426–1 of this title provides basic protection against the costs of hospital, related post-hospital, home health services, and hospice care in accordance with this part for (1) individuals who are age 65 or over and are eligible for retirement benefits under subchapter II of this chapter (or would be eligible for such benefits if certain government employment were covered employment under such subchapter) or under the railroad retirement system, (2) individuals under age 65 who have been entitled for not less than 24 months to benefits under subchapter II of this chapter (or would have been so entitled to such benefits if certain government employment were covered employment under such subchapter) or under the railroad retirement system on the basis of a disability, and (3) certain individuals who do not meet the conditions specified in either clause (1) or (2) but who are medically determined to have end stage renal disease.

Notes of Decisions
Cited in 419 cases (57 in the last 5 years), 1970–2026 · leading case: McCall v. PacifiCare of California, Inc.
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McCall v. PacifiCare of California, Inc. (2001) cal · cites it 2× “(42 U.S.C. § 1395c et seq.) Part B establishes a voluntary supplemental medical insurance program covering specified medical services, devices, and equipment.”
Heckler v. Ringer (1984) scotus · cites it 2× “Part A of the Act, 42 U. S. C. § 1395c et seq., provides insurance for the cost of hospital and related posthospital services, but the Act precludes reimbursement for any "items or services .”
Heckler v. Community Health Services of Crawford County, Inc. (1984) scotus · cites it 2× “In 1966 it entered into a contract with petitioner's predecessor, the Secretary of Health, Education, and Welfare, to provide home health care services to individuals eligible *55 for benefits under Part A of the Medicare program, 42 U. S. C. §§ 1395c to 1395i-2. Under the…”
Floyd Wood v. Tommy G. Thompson, . As Secretary of the Department of Health and Human Services (2001) ca7 · cites it 3× “The Secretary of Health and Human Services administers the Medicare program through the Health Care Financing Administration (HCFA), which enters into agreements with private contractors to administer payments of funds to hospitals and providers for covered services on behalf of…”
Fischer v. United States (2000) scotus · cites it 4× “These definitions support petitioner's assertion that qualifying patients receive benefits under the Medicare program. It is commonplace for individuals to refer to their retirement or health plans as "benefits.”
United States Ex Rel. Prather v. Brookdale Senior Living Cmtys., Inc. (2018) ca6 · cites it 2× “3d at 755 (citing 42 U.S.C. §§ 1395c and 1395k(a)(2)(A) ). These services include: "skilled nursing services, home health aide services, physical therapy, speech-language pathology services, occupational therapy services, and medical social services.”
United States Ex Rel. Prather v. Brookdale Senior Living Communities, Inc. (2016) ca6 · cites it 2× “42 U.S.C. § 1395c. Medicare Part B is “a voluntary insurance program to provide medical insurance benefits,” 42 U.”
Roberts v. United Healthcare Services, Inc. (2016) calctapp · cites it 3× “(United Healthcare), offers to persons eligible for Medicare benefits—chiefly, persons 65 and over or who are disabled (42 U.S.C. § 1395c)—several different health care plans under the Medicare Advantage program.”
Guillermina Parra v. Pacificare of Arizona, Inc. (2013) ca9 · cites it 2× “Medicare Part A covers inpatient hospital care, 42 U.S.C. §§ 1395c to 1395i-5, and Part B covers services and equipment, 42 U.”
State of Texas v. USA (2015) ca5 · cites it 2× “] to an alien who is lawfully present in the United States as determined by the Attorney General and, with respect to benefits payable under part A of such title [42 U.S.C. § 1395c et seq.], who was authorized to be employed with respect to any wages attributable to employment…”
Bio-Medical Applications of Tennessee, Inc. v. Central States Southeast & Southwest Areas Health & Welfare Fund (2011) ca6 · cites it 2× “2008) (citing 42 U.S.C. § 1395c). For many years, Medicare served as the primary payer of health costs for eligible individuals, but in 1980 Congress enacted the Medicare Secondary Payer Act to counteract escalating healthcare costs.”
Alfred H. Turecamo and Frances M. Turecamo v. Commissioner of Internal Revenue (1977) ca2 · cites it 4× “75 was paid by Medicare allowances pursuant to the provisions of Part A of Subchapter XVIII of the Social Security Act, “Hospital Insurance Benefits for Aged and Disabled,” 42 U.S.C. §§ 1395c to 1935i-2. The taxpayers paid the balance of the hospital charges not covered by Part…”
Show all 419 citing cases →
— 42 U.S.C. § 1395c(1) — 1 case
KODENKANDETH v. UPMC HEALTH PLAN, INC. (2024) pawd
— 42 U.S.C. § 1395c(2) — 1 case
Monmouth Medical Center v. Harris (1980) njd
— 42 U.S.C. § 1395c(l) — 1 case
Ina M. Overton v. United States (1980) ca8
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