‘‘(i) has been formally diagnosed by a 
qualified medical practitioner or therapist; 
and 
‘‘(ii) can be reasonably considered, in 
the judgment of such practitioner or thera-
pist, to be associated with exposure to the 
9/11 New York terrorist attacks. 
‘‘(3) CRITERIA.—Not later than 30 days after 
the date of establishment of the Consortium estab-
lished under section 3 of the 9/11 Comprehensive 
Health Benefits Act of 2006, the Secretary, in con-
sultation with such Consortium, shall initially de-
velop standardized criteria for medical practitioners 
to consult with for assistance in their determination 
of whether an individual has a 9/11 disaster-con-
nected health condition consistent with this sub-
section. The Secretary shall periodically review such 
criteria and may, from time to time and in consulta-
tion with the Consortium, modify such criteria as 
the Secretary determines appropriate. 
‘‘(4) APPEALS PROCESS.—The Secretary shall 
specify a process for the appeal of a determination 
that an individual is not eligible for benefits under 
this section. Such process shall be consistent with 
the process under section 1869 for the appeal of a 
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determination that an individual is entitled to bene-
fits under parts A and B. 
‘‘(5) TREATMENT OF NONRESIDENTS AND UN-
DOCUMENTED
ALIENS.—Nothing in this section 
shall be construed as making an individual ineligible 
for benefits under this section because the individual 
is not a resident of New York or the United States 
or because the individual is an alien or is not au-
thorized to reside in the United States. Nothing in 
this paragraph shall be construed to provide for any 
benefits under this title for items and services fur-
nished outside the United States, except as may oth-
erwise be authorized under this title. 
‘‘(c) 9/11-RELATED BENEFITS DEFINED.— 
‘‘(1) IN GENERAL.—For purposes of this sec-
tion, the term ‘9/11-related benefits’ means benefits 
under parts A, B, and D for the treatment of any 
9/11 disaster-related health condition, subject to the 
following modifications with respect to such treat-
ment: 
‘‘(A) NO COST-SHARING.—No deductibles, 
coinsurance, copayments, or other cost-sharing 
shall be applicable. 
‘‘(B) ELIMINATION
OF
DAY
OR
DOLLAR 
LIMITATIONS.—Any day or dollar limitations on 
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coverage with respect to such treatment, includ-
ing such limitations under sections 1812, 
1833(g), and 1860D–2(b)(3), shall not be ap-
plicable. 
‘‘(2) ENTITLEMENT WITHOUT PREMIUMS.—An 
individual entitled to 9/11-related benefits under this 
section is deemed to be entitled to benefits under 
parts A, B, and D with respect to such 9/11-related 
benefits without requirement for payment for any 
premium. The entitlement to such benefits shall 
begin on the date that the individual is determined 
to be eligible for such benefits, but in no case before 
the date of the enactment of this section. 
‘‘(3) RELATION TO PART C.—Except in the case 
of an individual enrolled under part A or B under 
subsection (d) or otherwise, 9/11-related benefits are 
not available through enrollment in a Medicare Ad-
vantage plan under part C. 
‘‘(d) ENROLLMENT OPTION FOR ADDITIONAL MEDI-
CARE BENEFITS.— 
‘‘(1) IN GENERAL.—With respect to the enroll-
ment option described in subsection (a)(2), an eligi-
ble individual may enroll under part A or B (or 
both), and under part D, in a manner and form pre-
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scribed in regulations. Such regulations shall provide 
for continuous open enrollment for such individuals. 
‘‘(2) PREMIUMS.— 
‘‘(A) IN GENERAL.—Except as provided in 
this paragraph, the premium for enrollment 
under part A under this subsection shall be the 
same as the premium established under sub-
section (d) of section 1818 for enrollment under 
such section, subject to any reduction provided 
under such subsection. 
‘‘(B) ELIMINATION
OF
PREMIUM
BASED 
ON
QUARTERS
OF
COVERAGE.—No premium 
shall be imposed under subparagraph (A) in the 
case of an individual if the individual would be 
entitled, based solely on the number of quarters 
of coverage under title II, to benefits under 
part A under section 226(a), 226(b), or 226A. 
‘‘(C) NO LATE ENROLLMENT PENALTY.— 
An individual enrolling under part A, B, or D 
under this subsection shall not be subject to 
any late enrollment penalty, including under 
sections 1839(b) and 1860D–13(b). 
‘‘(3) ENROLLMENT UNDER PARTS B AND D.— 
For purposes of parts B and D, in the case of an 
individual eligible to enroll under this subsection, the 
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individual’s initial enrollment period under such 
parts shall be treated as beginning on the date of 
such eligibility and having no end date. 
‘‘(4) COVERAGE.— 
‘‘(A) IN
GENERAL.—The period (in this 
subsection referred to as a ‘coverage period’) 
during which an individual enrolled under this 
subsection is entitled to benefits under the re-
spective part shall begin on the first day of the 
first month that begins at least 15 days after 
the date of the individual’s enrollment under 
such part. 
‘‘(B) TERMINATION.—An individual’s cov-
erage period under this subsection under a part 
shall continue until the individual’s enrollment 
under such part is terminated as follows: 
‘‘(i) As of the month following the 
month in which the individual files notice 
that the individual no longer wishes to be 
enrolled in the part under this subsection. 
‘‘(ii) For nonpayment of any applica-
ble premiums under such part. 
‘‘(iii) With respect to coverage under 
part D, as of the month in which the indi-
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