Questions billers ask › How does Medicare define Supplementary Medical Insurance (Part B)?
How does Medicare define Supplementary Medical Insurance (Part B)?
The rule, word for word
“(a) Statutory basis. The supplementary medical insurance (SMI) program is authorized by Part B of title XVIII of the Social Security Act. (1) Section 1831 of the Act establishes the program. (2) Sections 1836 and 1837 set forth the eligibility and enrollment requirements. (3) Section 1838 specifies the entitlement periods, which vary depending on the time and method of enrollment and on the basis for termination. (4) Section 1843 sets forth the requirements for State buy-in agreements under which States may enroll, and pay the SMI premiums for, eligible individuals who are also eligible for cash assistance or Medicaid. (5) Section 104(b) of the Social Security Amendments of 1965 (Pub. L. 89-87) specifies the limitations that apply to certain aliens and persons convicted of subversive activities. (6) Sections 1836(b) and 1837(n) of the Act provide for coverage of immunosuppressive drugs as described in section 1861(s)(2)(J) of the Act under Part B beginning on or after January 1, 2023, for eligible individuals whose benefits under Medicare Part A and eligibility to enroll in Part B on the basis of ESRD would otherwise end with the 36th month after the month in which the individual receives a kidney transplant by reason of section 226A(b)(2) of the Act. (b) Scope. This part sets forth the eligibility, enrollment, and entitlement requirements and procedures for the following: (1) [...]”
Published2026-04-06 Captured2026-04-06
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What our AI found in the sources
Medicare Supplementary Medical Insurance (SMI) is the voluntary insurance program established under Part B of title XVIII of the Social Security Act. Per 42 CFR § 407.1, section 1831 of the Act establishes the program. SMI is designed to supplement the basic hospital insurance coverage and is financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government, and certain deductible and cost-sharing provisions.
Also cited
Captured2026-05-26
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Captured2026-05-26
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If this comes up on one of your claims
The quoted paragraph above is what you would put in the appeal or the audit file, with its citation and dates. Verbatim does not tell you how to bill; it shows you the rule as published so the decision is yours and the proof is in writing.
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