---
kind: "section"
citation: "42 C.F.R. § 406.20"
title: "42"
number: "406.20"
heading: "Basic requirements."
url: "https://uscodex.org/cfr/42/406.20"
---

# §406.20. Basic requirements.

- (a) **General provisions.** Hospital insurance benefits are available to most individuals age 65 or over and to certain individuals under age 65 who do not qualify for those benefits under [subpart B](/cfr/42/subpartB.md) of this part and are willing to pay a monthly premium. This is called premium hospital insurance.
- (b) **Eligibility of individuals age 65 or over to enroll for premium hospital insurance.** Any individual is eligible to enroll for Medicare Part A if he or she—
  - (1) Has attained age 65;
  - (2) **Is a resident of the United States and is either—**
    - (i) A citizen of the United States; or
    - (ii) An alien lawfully admitted for permanent residence who has resided in the United States continuously for the 5-year period immediately preceding the month in which he or she meets all other requirements;
  - (3) Is not eligible for Part A benefits under subpart B of this part; and
  - (4) Is entitled to supplementary medical insurance (Part B of Medicare) or is eligible and has enrolled for it during an enrollment period.
- (c) **Eligibility of individuals under age 65 to enroll for premium hospital insurance.** An individual who has not attained age 65 is eligible to enroll for Medicare Part A if he or she meets the following conditions:
  - (1) Has been entitled to Medicare Part A (under [§ 406.12](/cfr/42/406.12.md) or [§ 406.15](/cfr/42/406.15.md)) on the basis of entitlement or deemed entitlement to social security disability benefits, as provided under [section 226(b)](/cfr/42/226.md?p=b) of the Act.
  - (2) **Continues to have a disabling physical or mental impairment.**
  - (3) Loses entitlement to disability benefits (and therefore also loses entitlement to Medicare Part A under [§ 406.12](/cfr/42/406.12.md)) solely because his or her earnings exceed the amount allowed under the social security regulations pertaining to “substantial gainful activity” ([20 CFR 404.1571-404.1574](/cfr/20/404.1571-404.1574.md)); and
  - (4) **Is not otherwise entitled to Medicare Part A.**

## Notes

### Amendments

[56 FR 38078, Aug. 12, 1991; 56 FR 50058, Oct. 3, 1991]

### Authority

Authority: 42 U.S.C. 1302, 1395i-2, 1395i-2a, 1395p, 1395q and 1395hh.

### Source

Source: 48 FR 12536, Mar. 25, 1983, unless otherwise noted. Redesignated at 51 FR 41338, Nov. 14, 1986.

### Amendments

[56 FR 38078, Aug. 12, 1991; 56 FR 50058, Oct. 3, 1991]