---
kind: "section"
citation: "20 C.F.R. § 422.510"
title: "20"
number: "422.510"
heading: "Applications and related forms used in the health insurance for the aged program."
url: "https://uscodex.org/cfr/20/422.510"
---

# §422.510. Applications and related forms used in the health insurance for the aged program.

- (a) **Application forms.** The following forms are prescribed for use in applying for entitlement to benefits under the health insurance for the aged program:
- (b) **Related forms.** The following are the prescribed forms for use in requesting payment for services under the hospital insurance benefits program and the supplementary medical insurance benefits program and other related forms:

## Notes

### Amendments

[32 FR 18030, Dec. 16, 1967, as amended at 38 FR 11451, May 8, 1973; 44 FR 34943, June 18, 1979]

### Authority

Authority: 42 U.S.C. 1320b-10(a)(2)(A).

### Source

Source: 32 FR 13653, Sept. 29, 1967, unless otherwise noted.

### Amendments

[32 FR 18030, Dec. 16, 1967, as amended at 38 FR 11451, May 8, 1973; 44 FR 34943, June 18, 1979]