POMS Reference

HI 00801: Hospital Insurance Entitlement

TN 25 (09-93)

CITATIONS:

Social Security Amendments of 1965 (P.L. 89-97—Sec. 103)

Regulations 42 CFR—Sec. 406.11

An individual is entitled to HI under the deemed insured provision beginning with the first month after 6/66 in which he/she:

  • files an application;

  • is not eligible for HI under the regular insured provision;

  • has attained age 65;

  • has, if he/she attains age 65 after 1967, not less than 3 QC's for each calendar year elapsing after 1966 and before the year of attainment of age 65 (an individual who attained age 65 before 1968 needs no QCs to be deemed insured for HI);

  • is a U.S. resident;

  • is a U.S. citizen or an alien lawfully admitted for permanent residence with 5 years continuous U.S. residence immediately preceding the month all other eligibility requirements are met;

  • is not covered, or would not be covered currently had he/she enrolled under the Federal Employees Health Benefits Act of 1959; and

  • has not been convicted of certain crimes against the U.S.