WHAT THE LAW DOINCongress, in plain words

The law › Title 42, The Public Health and Welfare › Chapter 7

42 U.S.C. 1395w-21: Eligibility, election, and enrollment

Created in 1997 by the Balanced Budget Act of 1997 (Public Law 105-33). Changed by 12 later laws. 1 new law this Congress changed it.

1 part of federal rules cite it as their authority, written by Centers for Medicare & Medicaid Services, Department of Health and Human Services (1).

This Congress

  • H.R. 7148 Consolidated Appropriations Act, 2026 · became law · changed (d)

How it got here

2016

  • Pub. L. 114–255, §17006(a)(1), struck out subpar. (A) designation and heading, substituted "In this subchapter," for "In this subchapter, subject to subparagraph (B),", and struck out subpar. (B), which provided a special rule for end-stage renal disease. (21st Century Cures Act) Law text · (a)
  • Pub. L. 114–255, §17005(1), inserted "from 2011 through 2018" after "45-day period" in heading and "and ending with 2018" after "beginning with 2011" in text. (21st Century Cures Act) Law text · (e)
  • Pub. L. 114–255, §17005(2), added subpar. (G). (21st Century Cures Act) Law text · (e)
  • Pub. L. 114–255, §17006(c)(2), added par. (3). (21st Century Cures Act) Law text · (i)

2015

  • Pub. L. 114–10, §209(b)(3), inserted concluding provisions. (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (a)
  • Pub. L. 114–10, §209(b)(1)(A), substituted "Subject to paragraph (4), such elections" for "Such elections". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (c)
  • Pub. L. 114–10, §209(b)(1)(B), added par. (4). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (c)
  • Pub. L. 114–10, §209(c), designated existing provisions as cl. (i), inserted heading, and added cl. (ii). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
  • Pub. L. 114–10, §209(c)(1), which directed the substitution of "Notifications required" for "Notification to newly eligible medicare advantage eligible individuals" in heading, was executed by making the substitution for "Notification to newly eligible Medicare+Choice eligible individuals" to refle… (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (d)
  • Pub. L. 114–10, §209(b)(2)(A), added subpar. (F). (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (e)
  • Pub. L. 114–10, §209(b)(2)(B)(i), substituted "paragraph (1), during the period described in paragraph (2)(F)," for "paragraph (1),". (Medicare Access and CHIP Reauthorization Act of 2015) Law text · (e)

2010

  • Pub. L. 111–148, §3201(e)(2)(A)(i), which directed that subpar. (C) be struck out, was repealed by Pub. L. 111–152, §1102(a). See Effective Date of 2010 Amendment note below. (Patient Protection and Affordable Care Act) Law text · (b)
  • Pub. L. 111–148, §3204(a)(1), amended subpar. (C) generally. Prior to amendment, subpar. (C) related to continuous open enrollment and disenrollment for first 3 months of a year after 2006. (Patient Protection and Affordable Care Act) Law text · (e)
  • Pub. L. 111–148, §3204(b)(2)(A), substituted ", 2008, 2009, and 2010" for "and succeeding years". (Patient Protection and Affordable Care Act) Law text · (e)
  • Pub. L. 111–148, §3204(b)(1), (2)(B), (3), added cl. (v). (Patient Protection and Affordable Care Act) Law text · (e)

2009

  • Pub. L. 111–5 substituted "1395ww(h)(3)(D), and 1395w–23(m)" for "and 1395ww(h)(3)(D)". (American Recovery and Reinvestment Act of 2009) Law text · (i)

2008

  • Pub. L. 110–275, §103(a)(1)(A)(i)(I)(aa), substituted ", subject to subsection (j)(2)(C), cash, gifts, prizes, or other monetary rebates" for "cash or other monetary rebates". (Medicare Improvements for Patients and Providers Act of 2008) Law text · (h)
  • Pub. L. 110–275, §103(a)(1)(A)(i)(I)(bb)–(III), added subpar. (C). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (h)
  • Pub. L. 110–275, §103(b)(1)(A), added subpar. (D). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (h)
  • Pub. L. 110–275, §103(c)(1), added par. (6). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (h)
  • Pub. L. 110–275, §103(d)(1), added par. (7). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (h)
  • Pub. L. 110–275, §103(a)(1)(A)(ii), added subsec. (j). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (j)
  • Pub. L. 110–275, §103(b)(1)(B), added par. (2). (Medicare Improvements for Patients and Providers Act of 2008) Law text · (j)

2007

  • Pub. L. 110–48, §2(1), substituted "the period beginning on January 1, 2007, and ending on July 31, 2007," for "2007 or 2008". Law text · (e)
  • Pub. L. 110–48, §2(2), substituted "the applicable period" for "year" in heading and "the period described in such clause" for "the year" in text. Law text · (e)

2006

  • Pub. L. 109–432 added subpar. (E). (Tax Relief and Health Care Act of 2006) Law text · (e)

2003

  • Pub. L. 108–173, §102(c)(1)(A), (C), inserted "(other than qualified prescription drug benefits)" after "benefits" in introductory provisions and inserted concluding provisions. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)
  • Pub. L. 108–173, §102(c)(1)(B), substituted comma for period at end. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)
  • Pub. L. 108–173, §221(a)(1), substituted "Coordinated care plans (including regional plans)" for "Coordinated care plans" in heading, inserted cl. (i) designation and heading before "Coordinated", and inserted "regional or local" before "preferred provider organization plans" and… (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)
  • Pub. L. 108–173, §231(a), added cl. (ii). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)
  • Pub. L. 108–173, §222(l)(3)(D), made technical amendment to reference in original act which appears in text as reference to subsection (e)(4)(A) of this section. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (a)
  • Pub. L. 108–173, §222(l)(3)(A)(i), (ii), substituted "an MA local plan" for "a plan" and "benefits under the original medicare fee-for-service program option" for "basic benefits described in section 1395w–22(a)(1)(A) of this title". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b)
  • Pub. L. 108–173, §222(l)(3)(A)(iii), substituted "in an MA local plan" for "in a Medicare+Choice plan" in introductory provisions. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b)
  • Pub. L. 108–173, §233(b)(1), struck out "on a demonstration basis" after "plans" in heading. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b)
  • Pub. L. 108–173, §233(b)(2), struck out first sentence which read as follows: "An individual is not eligible to enroll in an MSA plan under this part— (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b)
  • Pub. L. 108–173, §233(b)(3), struck out at end "The Secretary shall submit such a report, by not later than March 1, 2002, on whether the time limitation under subparagraph (A)(i) should be extended or removed and whether to change the numerical limitation under subparagraph (A)(… (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (b)
  • Pub. L. 108–173, §222(l)(3)(B)(i), added subpar. (F). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (d)
  • Pub. L. 108–173, §222(l)(3)(B)(ii), inserted ", including information on the single deductible (if applicable) under section 1395w–27a(b)(1) of this title" after "cost sharing". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (d)
  • Pub. L. 108–173, §222(l)(3)(B)(iii), substituted "monthly amount of the premium charged to an individual" for "Medicare+Choice monthly basic beneficiary premium and Medicare+Choice monthly supplemental beneficiary premium, if any, for the plan or, in the case of an MSA plan, t… (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (d)
  • Pub. L. 108–173, §222(l)(3)(B)(iv), reenacted heading without change and amended text generally. Prior to amendment, text read as follows: "Whether the organization offering the plan includes mandatory supplemental benefits in its base benefit package or offers optional supplemen… (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (d)
  • Pub. L. 108–173, §102(a)(4), inserted at end "If any portion of an individual's initial enrollment period under part B occurs after the end of the annual, coordinated election period described in paragraph (3)(B)(iii), the initial enrollment period under this part shall further exte… (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(1)(A), substituted "2005" and "2006" for "2004" and "2005", respectively, wherever appearing. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(6)(A), inserted ", subparagraph (C)(iii)," after "clause (ii)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(6)(B), substituted "clauses (ii) and (iii)" for "clause (ii)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(6)(C), added cl. (iii). (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(2), reenacted heading without change and amended text generally. Prior to amendment, text read as follows: "For purposes of this section, the term 'annual, coordinated election period' means, with respect to a year before 2003 and after 2005, the month of… (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(3)(A), inserted "and during the period described in subparagraph (B)(iii)" after "(beginning with 1999)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(3)(B), in heading, substituted "campaigns" for "campaign in 1998" and, in text, inserted at end "During the period described in subparagraph (B)(iii), the Secretary shall provide for an educational and publicity campaign to inform MA eligible individuals … (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §102(a)(1)(B), substituted "2006" for "2005" in two places. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §233(d)(1), inserted "or" at end. (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §233(d)(2), substituted semicolon for ", or". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §233(d)(3), struck out cl. (iii) which read as follows: "the month of November 1998;". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (e)
  • Pub. L. 108–173, §222(l)(3)(E), substituted "subsection (e)(1)" for "subsection (e)(1)(A)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
  • Pub. L. 108–173, §102(a)(5), inserted ", other than the period described in clause (iii) of such subsection" after "subsection (e)(3)(B)". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (f)
  • Pub. L. 108–173, §237(b)(2)(A)(i), inserted "1395w–23(a)(4)," after "Subject to sections 1395w–22(a)(5),". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (i)
  • Pub. L. 108–173, §237(b)(2)(A)(ii), inserted "1395w–23(a)(4)," after "Subject to sections". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (i)
  • Pub. L. 108–173, §221(d)(5), inserted "1395w–27a(h)," after "1395w–27(f)(2),". (Medicare Prescription Drug, Improvement, and Modernization Act of 2003) Law text · (i)

2002

  • Pub. L. 107–188, §532(a)(1), substituted "through 2004" for "through 2001" in heading and "during the period beginning January 1, 1998, and ending on December 31, 2004" for "during 1998, 1999, 2000, and 2001" in text. (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e)
  • Pub. L. 107–188, §532(a)(2), substituted "during 2005" for "during 2002" in heading. (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e)
  • Pub. L. 107–188, §532(a)(3), substituted "2005" for "2002" wherever appearing. (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e), (C)
  • Pub. L. 107–188, §532(a)(4), substituted "2004" for "2001". (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e)
  • Pub. L. 107–188, §532(c)(1)(A), substituted "means, with respect to a year before 2003 and after 2005, the month of November before such year and with respect to 2003, 2004, and 2005, the period beginning on November 15 and ending on December 31 of the year before such year" for … (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e)
  • Pub. L. 107–188, §532(a)(5), substituted "2005" for "2002" in introductory and concluding provisions. (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e)
  • Pub. L. 107–188, §532(c)(1)(B), substituted "during the annual, coordinated election period under paragraph (3) for each subsequent year" for "each subsequent year (as provided in paragraph (3))". (Public Health Security and Bioterrorism Preparedness and Response Act of 2002) Law text · (e)

2000

  • Pub. L. 106–554, §1(a)(6) [title VI, §620(a)], substituted "except that—" and cls. (i) and (ii) for "except that an individual who develops end-stage renal disease while enrolled in a Medicare+Choice plan may continue to be enrolled in that plan." (Consolidated Appropriations Act, 2001) Law text · (a)
  • Pub. L. 106–554, §1(a)(6) [title VI, §606(a)(2)(C)], designated existing provisions as cl. (i), inserted heading, and added cl. (ii). (Consolidated Appropriations Act, 2001) Law text · (d)
  • Pub. L. 106–554, §1(a)(6) [title VI, §619(a)], struck out ", except that if such election or change is made after the 10th day of any calendar month, then the election or change shall not take effect until the first day of the second calendar month following the date on which the el… (Consolidated Appropriations Act, 2001) Law text · (f)
  • Pub. L. 106–554, §1(a)(6) [title VI, §613(a)(1)], inserted "(or 10 days in the case described in paragraph (5))" after "45 days". (Consolidated Appropriations Act, 2001) Law text · (h)
  • Pub. L. 106–554, §1(a)(6) [title VI, §613(a)(2)], added par. (5). (Consolidated Appropriations Act, 2001) Law text · (h)

1999

  • Pub. L. 106–113, §1000(a)(6) [title V, §501(c)(1)], inserted "and except as provided in subparagraph (C)" after "may otherwise provide". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (b)
  • Pub. L. 106–113, §1000(a)(6) [title V, §501(c)(2)], added subpar. (C). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (b)
  • Pub. L. 106–113, §1000(a)(6) [title V, §501(b)(1)], inserted "and subparagraph (D)" after "clause (ii)". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (e)
  • Pub. L. 106–113, §1000(a)(6) [title V, §501(b)(2)], inserted "and subparagraph (D)" after "clause (ii)". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (e)
  • Pub. L. 106–113, §1000(a)(6) [title V, §501(b)(3)], added subpar. (D). (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (e)
  • Pub. L. 106–113, §1000(a)(6) [title V, §519(a)], substituted "During the fall season" for "In the month of November". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (e)
  • Pub. L. 106–113, §1000(a)(6) [title V, §501(a)(1)], added subpar. (A) and struck out former subpar. (A) which read as follows: "the organization's or plan's certification under this part has been terminated or the organization has terminated or otherwise discontinued providing th… (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (e)
  • Pub. L. 106–113, §1000(a)(6) [title V, §502(a)], inserted "or change" before "is made" and ", except that if such election or change is made after the 10th day of any calendar month, then the election or change shall not take effect until the first day of the second calendar month f… (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (f)
  • Pub. L. 106–113, §1000(a)(6) [title III, §321(k)(6)(A)], struck out "and" after "1395w–27(f)(2),". (Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 2000) Law text · (i)

Text, outline and history from the official U.S. Code (2024 edition) on GovInfo, published by the Office of the Law Revision Counsel. Changes made after that edition appear under This Congress.