Medicare Supplementary Medical Insurance
Program Funding
Annual program obligations reported to SAM.gov.
Program Objective
To provide medical insurance protection for covered services to persons age 65 or over, to certain disabled persons and to individuals with end-stage renal disease. Enrollment in Part B is voluntary.
Eligibility
Eligible Applicants
- State
All persons who are eligible for premium-free hospital insurance benefits (see 93.773), and persons age 65 and older who reside in the United States and are either citizens or aliens lawfully admitted for permanent residence who have resided in the United States continuously during the five years immediately preceding the month in which the application for enrollment is filed, may voluntarily enroll for Part B supplementary medical insurance (SMI). The beneficiary pays a monthly premium and an annual deductible. Beginning in calendar year 2008, the Part B premiums have been set based upon beneficiary income. The calendar year 2025 premiums range from $185.00 to $628.90 per month. The annual deductible is $257.00. Some States and other third parties may pay the SMI PART B premium on behalf of qualifying individuals.
How to Apply
Award Procedure
After review of the application is completed, the applicant will be notified by mail.
Program details & compliance
Description
To provide medical insurance protection for covered services to persons age 65 or over, to certain disabled persons and to individuals with end-stage renal disease. Enrollment in Part B is voluntary.
Mission Categories
Primary: General Health and Medical
Use of Funds
Allowed Uses
Managed care benefits are paid on the basis of Medicare capitation rates. Fee-for-service benefits are paid on the basis of fee schedules or other approved amounts for services furnished by physicians and other suppliers of medical services to aged or disabled enrollees. Benefits are paid on the basis of prospective payment systems for certain covered services furnished by participating providers such as hospitals and home health agencies.
Required Documentation
Proof of age, disability or lawful admission status.