GroundRules
42 CFR 408.63: Billing procedures when monthly benefits are less than monthly premiums.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER B—MEDICARE PROGRAM
- PART 408—PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE
- Subpart D—Direct Remittance: Individual Payment
If monthly benefits are less than monthly premiums, the following procedures apply:
(a) Notice of amount due. At the beginning of SMI entitlement, and at the beginning of each succeeding calendar year, SSA—
(1) Notifies the enrollee of the amount of benefits payable for the rest of the year and the total premiums due for those same months; and
(2) Bills the enrollee for the difference.
(b) Notice of amount overdue. At the beginning of each succeeding calendar year, SSA—
(1) Notifies the enrollee of any amounts overdue for premiums for the preceding calendar year; and
(2) Indicates that if the amount still overdue on April 30 is equal to or greater than the premium for 3 months, SMI coverage will terminate on that date.
Collected 2026-08-27T02:26:11Z. Source file · JSON