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42 U.S.C. § 1395w–6 — Payment of premiums

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395w–6 — Payment of premiums

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Source location: Title 42, Chapter 7, § 1395w–6; chapter-007-social-security.md

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**(a) Deductions from section 402 or 423 monthly benefits** (1) In the case of an individual who is entitled to monthly benefits under section 402 or 423 of this title, his monthly premiums under this part shall (except as provided in subsections (b)(1) and (c)) be collected by deducting the amount thereof from the amount of such monthly benefits. Such deduction shall be made in such manner and at such times as the Commissioner of Social Security shall by regulation prescribe. Such regulations shall be prescribed after consultation with the Secretary. (2) The Secretary of the Treasury shall, from time to time, transfer from the Federal Old-Age and Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph (1) for the period to which such transfer relates from benefits under section 402 or 423 of this title which are payable from such Trust Fund. Such transfer shall be made on the basis of a certification by the Commissioner of Social Security and shall be appropriately adjusted to the extent that prior transfers were too great or too small. **(b) Deductions from railroad retirement annuities or pensions** (1) In the case of an individual who is entitled to receive for a month an annuity under the Railroad Retirement Act of 1974 [[45 U.S.C. 231](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title45-section231&num=0&edition=prelim) et seq.] (whether or not such individual is also entitled for such month to a monthly insurance benefit under [section 402 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section402&num=0&edition=prelim)), his monthly premiums under this part shall (except as provided in subsection (c)) be collected by deducting the amount thereof from such annuity or pension. Such deduction shall be made in such manner and at such times as the Secretary shall by regulations prescribe. Such regulations shall be prescribed only after consultation with the Railroad Retirement Board. (2) The Secretary of the Treasury shall, from time to time, transfer from the Railroad Retirement Account to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph (1) for the period to which such transfer relates. Such transfers shall be made on the basis of a certification by the Railroad Retirement Board and shall be appropriately adjusted to the extent that prior transfers were too great or too small. **(c) Portion of monthly premium in excess of deducted amount** If an individual to whom subsection (a) or (b) applies estimates that the amount which will be available for deduction under such subsection for any premium payment period will be less than the amount of the monthly premiums for such period, he may (under regulations) pay to the Secretary such portion of the monthly premiums for such period as he desires. **(d) Deductions from civil service retirement annuities** (1) In the case of an individual receiving an annuity under subchapter III of chapter 83 of title 5 or any other law administered by the Director of the Office of Personnel Management providing retirement or survivorship protection, to whom neither subsection (a) nor subsection (b) applies, his monthly premiums under this part (and the monthly premiums of the spouse of such individual under this part if neither subsection (a) nor subsection (b) applies to such spouse and if such individual agrees) shall, upon notice from the Secretary of Health and Human Services to the Director of the Office of Personnel Management, be collected by deducting the amount thereof from each installment of such annuity. Such deduction shall be made in such manner and at such times as the Director of the Office of Personnel Management may determine. The Director of the Office of Personnel Management shall furnish such information as the Secretary of Health and Human Services may reasonably request in order to carry out his functions under this part with respect to individuals to whom this subsection applies. A plan described in section 8903 or 8903a of title 5 may reimburse each annuitant enrolled in such plan an amount equal to the premiums paid by him under this part if such reimbursement is paid entirely from funds of such plan which are derived from sources other than the contributions described in section 8906 of such title. (2) The Secretary of the Treasury shall, from time to time, but not less often than quarterly, transfer from the Civil Service Retirement and Disability Fund, or the account (if any) applicable in the case of such other law administered by the Director of the Office of Personnel Management, to the Federal Supplementary Medical Insurance Trust Fund the aggregate amount deducted under paragraph (1) for the period to which such transfer relates. Such transfer shall be made on the basis of a certification by the Director of the Office of Personnel Management and shall be appropriately adjusted to the extent that prior transfers were too great or too small. **(e) Manner and time of payment prescribed by Secretary** In the case of an individual who participates in the insurance program established by this part but with respect to whom none of the preceding provisions of this section applies, or with respect to whom subsection (c) applies, the premiums shall be paid to the Secretary at such times, and in such manner, as the Secretary shall by regulations prescribe. **(f) Deposit of amounts in Treasury** Amounts paid to the Secretary under subsection (c) or (e) shall be deposited in the Treasury to the credit of the Federal Supplementary Medical Insurance Trust Fund. **(g) Premium payability period** In the case of an individual who participates in the insurance program established by this part, premiums shall be payable for the period commencing with the first month of his coverage period and ending with the month in which he dies or, if earlier, in which his coverage under such program terminates. **(h) Exempted monthly benefits** In the case of an individual who is enrolled under the program established by this part as a member of a coverage group to which an agreement with a State entered into pursuant to [section 1395v of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395v&num=0&edition=prelim) is applicable, subsections (a), (b), (c), and (d) of this section shall not apply to his monthly premium for any month in his coverage period which is determined under [section 1395v(d) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395v/d&num=0&edition=prelim). **(i) Adjustments for individuals enrolled in Medicare+Choice plans** In the case of an individual enrolled in a Medicare+Choice plan, the Secretary shall provide for necessary adjustments of the monthly beneficiary premium to reflect 80 percent of any reduction elected under [section 1395w–24(f)(1)(E) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w–24/f/1/E&num=0&edition=prelim) and to reflect any credit provided under section 1395w–24(b)(1)(C)(iv) 11 See References in Text note below. of this title. To the extent to which the Secretary determines that such an adjustment is appropriate, with the concurrence of any agency responsible for the administration of such benefits, such premium adjustment may be provided directly, as an adjustment to any social security, railroad retirement, or civil service retirement benefits, or, in the case of an individual who receives medical assistance under subchapter XIX for medicare costs described in [section 1396d(p)(3)(A)(ii) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396d/p/3/A/ii&num=0&edition=prelim), as an adjustment to the amount otherwise owed by the State for such medical assistance.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 704 — Use of allotment funds

**(a) Covered services** Except as otherwise provided under this section, a State may use amounts paid to it under [section 703 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section703&num=0&edition=prelim) for the provision of health services and related activities (including planning, administration, education, and evaluation and including payment of salaries and other related expenses of National Health Service Corps personnel) consistent with its application transmitted under [section 705(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section705/a&num=0&edition=prelim). **(b) Restrictions** Amounts described in subsection (a) may not be used for— (1) inpatient services, other than inpatient services provided to children with special health care needs or to high-risk pregnant women and infants and such other inpatient services as the Secretary may approve; (2) cash payments to intended recipients of health services; (3) the purchase or improvement of land, the purchase, construction, or permanent improvement (other than minor remodeling) of any building or other facility, or the purchase of major medical equipment; (4) satisfying any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; (5) providing funds for research or training to any entity other than a public or nonprofit private entity; or (6) payment for any item or service (other than an emergency item or service) furnished— (A) by an individual or entity during the period when such individual or entity is excluded under this subchapter or subchapter XVIII, XIX, or XX pursuant to section 1320a–7, 1320a–7a, 1320c–5, or 1395u(j)(2) of this title, or (B) at the medical direct

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395v — Scope of benefits; definitions

**(a) Scope of benefits** The benefits provided to an individual by the insurance program established by this part shall consist of— (1) entitlement to have payment made to him or on his behalf (subject to the provisions of this part) for medical and other health services, except those described in subparagraphs (B) and (D) of paragraph (2) and subparagraphs (E) and (F) of [section 1395u(b)(6) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395u/b/6&num=0&edition=prelim); and (2) entitlement to have payment made on his behalf (subject to the provisions of this part) for— (A) home health services (other than items described in subparagraph (G) or subparagraph (I)); (B) medical and other health services (other than items described in subparagraph (G) or subparagraph (I)) furnished by a provider of services or by others under arrangement with them made by a provider of services, excluding— (i) physician services except where furnished by— (I) a resident or intern of a hospital, or (II) a physician to a patient in a hospital which has a teaching program approved as specified in paragraph (6) of [section 1395x(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/b&num=0&edition=prelim) (including services in conjunction with the teaching programs of such hospital whether or not such patient is an inpatient of such hospital) where the conditions specified in paragraph (7) of such section are met, (ii) services for which payment may be made pursuant to [section 1395n(b)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395n/b/2&num=0&edition=prelim), (iii) services described by [section 1395x(s)(2)(K)(i) of

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Federal law — U.S. Code and appendices · legal_authorities

45 U.S.C. § 231t — Short title

This subchapter may be cited as the “Railroad Retirement Act of 1974”.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 402 — Old-age and survivors insurance benefit payments

**(a) Old-age insurance benefits** Every individual who— (1) is a fully insured individual (as defined in [section 414(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section414/a&num=0&edition=prelim)), (2) has attained age 62, and (3) has filed application for old-age insurance benefits or was entitled to disability insurance benefits for the month preceding the month in which he attained retirement age (as defined in section 416(l) of this title), shall be entitled to an old-age insurance benefit for each month, beginning with— (A) in the case of an individual who has attained retirement age (as defined in section 416(l) of this title), the first month in which such individual meets the criteria specified in paragraphs (1), (2), and (3), or (B) in the case of an individual who has attained age 62, but has not attained retirement age (as defined in section 416(l) of this title), the first month throughout which such individual meets the criteria specified in paragraphs (1) and (2) (if in that month he meets the criterion specified in paragraph (3)), and ending with the month preceding the month in which he dies. Except as provided in subsection (q) and subsection (w), such individual’s old-age insurance benefit for any month shall be equal to his primary insurance amount (as defined in [section 415(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section415/a&num=0&edition=prelim)) for such month. **(b) Wife’s insurance benefits** (1) The wife (as defined in [section 416(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section416/b&num=0&edition=prelim)) and every divorced wife (as defined in [section 416(d) of this title](https://uscode.house.gov/

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Federal law — U.S. Code and appendices · legal_authorities

45 U.S.C. § 231 — Definitions

For the purposes of this subchapter— **(a)** (1) The term “employer” shall include— (i) any carrier by railroad subject to the jurisdiction of the Surface Transportation Board under part A of subtitle IV of title 49; (ii) any company which is directly or indirectly owned or controlled by, or under common control with, one or more employers as defined in paragraph (i) of this subdivision, and which operates any equipment or facility or performs any service (except trucking service, casual service, and the casual operation of equipment or facilities) in connection with the transportation of passengers or property by railroad, or the receipt, delivery, elevation, transfer in transit, refrigeration or icing, storage, or handling of property transported by railroad; (iii) any receiver, trustee, or other individual or body, judicial or otherwise, when in the possession of the property or operating all or any part of the business of any employer as defined in paragraph (i) or (ii) of this subdivision; (iv) any railroad association, traffic association, tariff bureau, demurrage bureau, weighing and inspection bureau, collection agency and any other association, bureau, agency, or organization which is controlled and maintained wholly or principally by two or more employers as defined in paragraph (i), (ii), or (iii) of this subdivision and which is engaged in the performance of services in connection with or incidental to railroad transportation; and (v) any railway labor organization, national in scope, which has been or may be organized in accordance with the provisions of the Railway Labor Act, as amended [[45 U.S.C. 151](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title45-section151&num=0&edition=prelim) et seq.], and its State and National

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 423 — Disability insurance benefit payments

**(a) Disability insurance benefits** (1) Every individual who— (A) is insured for disability insurance benefits (as determined under subsection (c)(1)), (B) has not attained retirement age (as defined in section 416(l) of this title), (C) if not a United States citizen or national— (i) has been assigned a social security account number that was, at the time of assignment, or at any later time, consistent with the requirements of subclause (I) or (III) of [section 405(c)(2)(B)(i) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section405/c/2/B/i&num=0&edition=prelim); or (ii) at the time any quarters of coverage are earned— (I) is described in subparagraph (B) or (D) of [section 1101(a)(15) of title 8](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title8-section1101/a/15&num=0&edition=prelim), (II) is lawfully admitted temporarily to the United States for business (in the case of an individual described in such subparagraph (B)) or the performance as a crewman (in the case of an individual described in such subparagraph (D)), and (III) the business engaged in or service as a crewman performed is within the scope of the terms of such individual’s admission to the United States.11 So in original. The period probably should be a comma. (D) has filed application for disability insurance benefits, and (E) is under a disability (as defined in subsection (d)) shall be entitled to a disability insurance benefit (i) for each month beginning with the first month after his waiting period (as defined in subsection (c)(2)) in which he becomes so entitled to such insurance benefits, (ii) in the case of an individual who has been medically determined to have amyotrophic lateral sclerosi

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 401 — Trust Funds

**(a) Federal Old-Age and Survivors Insurance Trust Fund** There is hereby created on the books of the Treasury of the United States a trust fund to be known as the “Federal Old-Age and Survivors Insurance Trust Fund”. The Federal Old-Age and Survivors Insurance Trust Fund shall consist of the securities held by the Secretary of the Treasury for the Old-Age Reserve Account and the amount standing to the credit of the Old-Age Reserve Account on the books of the Treasury on January 1, 1940, which securities and amount the Secretary of the Treasury is authorized and directed to transfer to the Federal Old-Age and Survivors Insurance Trust Fund, and, in addition, such gifts and bequests as may be made as provided in subsection (i)(1), and such amounts as may be appropriated to, or deposited in, the Federal Old-Age and Survivors Insurance Trust Fund as hereinafter provided. There is hereby appropriated to the Federal Old-Age and Survivors Insurance Trust Fund for the fiscal year ending June 30, 1941, and for each fiscal year thereafter, out of any moneys in the Treasury not otherwise appropriated, amounts equivalent to 100 per centum of— (1) the taxes (including interest, penalties, and additions to the taxes) received under subchapter A of chapter 9 of the Internal Revenue Code of 1939 (and covered into the Treasury) which are deposited into the Treasury by collectors of internal revenue before January 1, 1951; and (2) the taxes certified each month by the Commissioner of Internal Revenue as taxes received under subchapter A of chapter 9 of such Code which are deposited into the Treasury by collectors of internal revenue after December 31, 1950, and before January 1, 1953, with respect to assessments of such taxes made before January 1, 1951; and (3) the taxes imposed by

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Federal law — U.S. Code and appendices · legal_authorities

5 U.S.C. § 8903a — Additional health benefits plans

**(a)** In addition to any plan under [section 8903 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8903&num=0&edition=prelim), the Office of Personnel Management may contract for or approve one or more health benefits plans under this section. **(b)** A plan under this section may not be contracted for or approved unless it— (1) is sponsored or underwritten, and administered, in whole or substantial part, by an employee organization described in [section 8901(8)(B) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8901/8/B&num=0&edition=prelim); (2) offers benefits of the types named by paragraph (1) or (2) of [section 8904 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8904&num=0&edition=prelim) or both; (3) provides for benefits only by paying for, or providing reimbursement for, the cost of such benefits (as provided for under paragraph (1) or (2) of [section 8903 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section8903&num=0&edition=prelim)) or a combination thereof; and (4) is available only to individuals who, at the time of enrollment, are full members of the organization and to members of their families. **(c)** A contract for a plan approved under this section shall require the carrier— (1) to enter into an agreement approved by the Office with an underwriting subcontractor licensed to issue group health insurance in all the States and the District of Columbia; or (2) to demonstrate ability to meet reasonable minimum financial standards prescribed by the Office. **(d)** For the purpose of this section, an individual shall be considered a full member of an organization if such individual is e

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395r — Protecting residents of long-term care facilities

(1) **National Training Institute for surveyors** (A) *In general* — The Secretary of Health and Human Services shall enter into a contract with an entity for the purpose of establishing and operating a National Training Institute for Federal and State surveyors. Such Institute shall provide and improve the training of surveyors with respect to investigating allegations of abuse, neglect, and misappropriation of property in programs and long-term care facilities that receive payments under title XVIII or XIX of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq.]. (B) *Activities carried out by the Institute* — The contract entered into under subparagraph (A) shall require the Institute established and operated under such contract to carry out the following activities: (i) Assess the extent to which State agencies use specialized surveyors for the investigation of reported allegations of abuse, neglect, and misappropriation of property in such programs and long-term care facilities. (ii) Evaluate how the competencies of surveyors may be improved to more effectively investigate reported allegations of such abuse, neglect, and misappropriation of property, and provide feedback to Federal and State agencies on the evaluations conducted. (iii) Provide a national program of training, tools, and technical assistance to Federal and State surveyors on investigating reports of such abuse, neglect, and misappropriation of property. (iv) Develop and disseminate information on best practices for the investigation of such abuse, neglect, and misappropriation of property. (v) Assess the performance of State complaint intake systems, in orde

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Federal law — U.S. Code and appendices · legal_authorities

45 U.S.C. § 231 — Definitions

Page 33 TITLE 45—RAILROADS § 231 Pub. L. 92–46, § 5, July 2, 1971, 85 Stat. 101, provided for 10 per cent increases in pensions under section 228f of this title, annuities under subchapter II of this chapter, certain survivor annuities, and certain widows’ and widowers’ insurance annuities. Pub. L. 91–377, § 4(b)(1), Aug. 12, 1970, 84 Stat. 792, pro- vided for 15 per cent increases in pensions under section 228f of this title, annuities under subchapter II of this chapter, certain survivor annuities, and certain wid- ows’ and widowers’ insurance annuities, provided that there would be a reduction in the amount of the in- crease where the recipient was also a recipient of cer- tain social security benefits. Pub. L. 90–257, § 107, Feb. 15, 1968, 82 Stat. 22, provided for certain increases in pensions under section 228f of this title, annuities under subchapter II of this chapter, survivor annuities and widows’ and widowers’ insur- ance annuities, provided that there would be a reduc- tion in the amount of the increase where the recipient was also a recipient of certain social security benefits. Pub. L. 89–699, § 201(g), Oct. 30, 1966, 80 Stat. 1077, pro- vided for 7 per cent increases in pensions under section 228f of this title, annuities under subchapter II of this chapter, certain survivor annuities, and certain wid- ows’ and widowers’ insurance annuities, provided that there would be a reduction in the amount of the in- crease where the recipient was also a recipient of cer- tain social security benefits. PERMANENCY OF INCREASES IN CERTAIN PENSIONS AND ANNUITIES Pub. L. 92–460, § 6, Sept. 4, 1972, 86 Stat. 767, provided that it was the policy of Congress that the 20 per cent increase in pension and annuity benefits provided by section 2 of Pub.

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