I 
109TH CONGRESS 
1ST SESSION H. R. 3654 
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 
SEPTEMBER 6, 2005 
Mr. ANDREWS introduced the following bill; which was referred to the Com-
mittee 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘International U.S. 
Seniors Act of 2005’’.
SEC. 2. MEDICARE PART B SPECIAL ENROLLMENT PERIOD 
AND WAIVER OF PART B LATE ENROLLMENT 
PENALTY AND MEDIGAP SPECIAL OPEN EN-
ROLLMENT PERIOD FOR CERTAIN INDIVID-
UALS RESIDING ABROAD. 
(a) MEDICARE PART B SPECIAL ENROLLMENT PE-
RIOD; WAIVER OF PART B PENALTY FOR LATE ENROLL-
MENT.— 
(1) IN GENERAL.—In the case of any eligible 
individual (as defined in subsection (c)(1)), the Sec-
retary of Health and Human Services shall provide 
for a special enrollment period during which the in-
dividual may enroll under part B of title XVIII of 
the Social Security Act. Such period shall be for a 
period of 8 months and shall begin with the first 
month that begins on or after the date the eligible 
individual first resides in the United States after the 
time described in subsection (c)(1)(B). 
(2) COVERAGE PERIOD.—In the case of an eli-
gible individual who enrolls during the special enroll-
ment period provided under paragraph (1), the cov-
erage period under part B of title XVIII of the So-
cial Security Act shall begin on the first day of the 
month following the month in which the individual 
enrolls.
(3) WAIVER
OF
PART
B
LATE
ENROLLMENT 
PENALTY.—In the case of an eligible individual who 
enrolls during the special enrollment period provided 
under paragraph (1), there shall be no increase pur-
suant to section 1839(b) of the Social Security Act 
(42 U.S.C. 1395r(b)) in the monthly premium under 
part B of title XVIII of such Act. 
(b) MEDIGAP SPECIAL OPEN ENROLLMENT PE-
RIOD.—Notwithstanding any other provision of law, an 
issuer of a medicare supplemental policy (as defined in 
section 1882(g) of the Social Security Act (42 U.S.C. 
1395ss(g))— 
(1) may not deny or condition the issuance or 
effectiveness of a medicare supplemental policy; and 
(2) may not discriminate in the pricing of the 
policy on the basis of the individual’s health status, 
medical condition (including both physical and men-
tal illnesses), claims experience, receipt of health 
care, medical history, genetic information, evidence 
of insurability (including conditions arising out of 
acts of domestic violence), or disability; 
in the case of an eligible individual who seeks to enroll 
during the 6-month period described in subsection (a)(1). 
(c) DEFINITIONS.—In this section:
(1) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 
individual’’ means an individual— 
(A) who, as of the date of the enactment 
of this Act, has attained 65 years of age and 
was eligible to enroll under part B of title 
XVIII of the Social Security Act, and 
(B) who at the time the individual first 
satisfied paragraph (1) or (2) of section 1836 
of the Social Security Act (42 U.S.C. 1395o)— 
(i) was not residing in a State (as de-
termined by the Secretary of Health and 
Human Services for purposes of such sec-
tion 1836), and 
(ii) did not elect to enroll (or to be 
deemed enrolled) under section 1837 of the 
Social Security Act (42 U.S.C. 1395p) 
during the individual’s initial enrollment 
period. 
(2) STATE.—The term ‘‘State’’ has the mean-
ing given that term in section 410(5) of the Social 
Security Act (42 U.S.C. 610(5)), and includes the 
Commonwealth of the Northern Marianas and the 
Trust Territory of the Pacific Islands.
SEC. 3. SENSE OF THE CONGRESS ON THE NEED FOR AN 
INTERNATIONAL CONVENTION FOR REIM-
BURSEMENT OF THE COSTS OF HEALTH 
CARE COVERAGE FOR FOREIGN SENIOR CITI-
ZENS. 
It is the sense of the Congress that the United States 
should enter into an international convention with respect 
to individuals aged 65 or older who live abroad under 
which the nation of which the individual is a citizen agrees 
to reimburse another nation in which the individual law-
fully resides for the costs of health care furnished to the 
individual while residing in that nation. 
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