I 

108TH CONGRESS 

1ST SESSION H. R. 1880

To amend title XVIII of the Social Security Act to provide certain Medicare 

beneficiaries living abroad a special Medicare part B enrollment period 

during which the late enrollment penalty is waived and a special Medigap 

open enrollment period during which no underwriting is permitted. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 30, 2003

Mr. ANDREWS introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL

To amend title XVIII of the Social Security Act to provide 

certain Medicare beneficiaries living abroad a special 

Medicare part B enrollment period during which the 

late enrollment penalty is waived and a special Medigap 

open enrollment period during which no underwriting 

is permitted.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘International U.S. 

5 Seniors Act of 2003’’. 
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1 SEC. 2. MEDICARE PART B SPECIAL ENROLLMENT PERIOD 

2 AND WAIVER OF PART B LATE ENROLLMENT 

3 PENALTY AND MEDIGAP SPECIAL OPEN EN4 ROLLMENT PERIOD FOR CERTAIN INDIVID5 UALS RESIDING ABROAD. 

6 (a) MEDICARE PART B SPECIAL ENROLLMENT PE7 RIOD; WAIVER OF PART B PENALTY FOR LATE ENROLL8 MENT.—

9 (1) IN GENERAL.—In the case of any eligible 

10 individual (as defined in subsection (c)(1)), the Sec11 retary of Health and Human Services shall provide 

12 for a special enrollment period during which the in13 dividual may enroll under part B of title XVIII of 

14 the Social Security Act. Such period shall be for a 

15 period of 8 months and shall begin with the first 

16 month that begins on or after the date the eligible 

17 individual first resides in the United States after the 

18 time described in subsection (c)(1)(B). 

19 (2) COVERAGE PERIOD.—In the case of an eli20 gible individual who enrolls during the special enroll21 ment period provided under paragraph (1), the cov22 erage period under part B of title XVIII of the So23 cial Security Act shall begin on the first day of the 

24 month following the month in which the individual 

25 enrolls. 
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1 (3) WAIVER OF PART B LATE ENROLLMENT

2 PENALTY.—In the case of an eligible individual who 

3 enrolls during the special enrollment period provided 

4 under paragraph (1), there shall be no increase pur5 suant to section 1839(b) of the Social Security Act 

6 (42 U.S.C. 1395r(b)) in the monthly premium under 

7 part B of title XVIII of such Act. 

8 (b) MEDIGAP SPECIAL OPEN ENROLLMENT PE9 RIOD.—Notwithstanding any other provision of law, an 

10 issuer of a medicare supplemental policy (as defined in 

11 section 1882(g) of the Social Security Act (42 U.S.C. 

12 1395ss(g))—

13 (1) may not deny or condition the issuance or 

14 effectiveness of a medicare supplemental policy; and 

15 (2) may not discriminate in the pricing of the 

16 policy on the basis of the individual’s health status, 

17 medical condition (including both physical and men18 tal illnesses), claims experience, receipt of health 

19 care, medical history, genetic information, evidence 

20 of insurability (including conditions arising out of 

21 acts of domestic violence), or disability; 

22 in the case of an eligible individual who seeks to enroll 

23 during the 6-month period described in subsection (a)(1). 

24 (c) DEFINITIONS.—In this section: 
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1 (1) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 

2 individual’’ means an individual—

3 (A) who, as of the date of the enactment 

4 of this Act, has attained 65 years of age and 

5 was eligible to enroll under part B of title 

6 XVIII of the Social Security Act, and 

7 (B) who at the time the individual first 

8 satisfied paragraph (1) or (2) of section 1836 

9 of the Social Security Act (42 U.S.C. 1395o)—

10 (i) was not residing in a State (as de11 termined by the Secretary of Health and 

12 Human Services for purposes of such sec13 tion 1836), and 

14 (ii) did not elect to enroll (or to be 

15 deemed enrolled) under section 1837 of the 

16 Social Security Act (42 U.S.C. 1395p) 

17 during the individual’s initial enrollment 

18 period. 

19 (2) STATE.—The term ‘‘State’’ has the mean20 ing given that term in section 410(5) of the Social 

21 Security Act (42 U.S.C. 610(5)), and includes the 

22 Commonwealth of the Northern Marianas and the 

23 Trust Territory of the Pacific Islands. 
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1 SEC. 3. SENSE OF THE CONGRESS ON THE NEED FOR AN 

2 INTERNATIONAL CONVENTION FOR REIM3 BURSEMENT OF THE COSTS OF HEALTH 

4 CARE COVERAGE FOR FOREIGN SENIOR CITI5 ZENS. 

6 It is the sense of the Congress that the United States 

7 should enter into an international convention with respect 

8 to individuals aged 65 or older who live abroad under 

9 which the nation of which the individual is a citizen agrees 

10 to reimburse another nation in which the individual law11 fully resides for the costs of health care furnished to the 

12 individual while residing in that nation.

Æ