TN 57 (02-23)

HI 00801.006 Requirements for Entitlement - Regular Insured Provision


Social Security Act 226(a); Railroad Retirement Act—Sec. 21; and Regulations 42 CFR 406.10



A. Definitions

1. RSI benefit

RSI benefit means any monthly benefit payable under section 202 of the Act.

  • Retirement benefits, spouse's benefits and surviving spouse's benefits are examples of RSI benefits.

  • Payments under sections 411 and 412 of 38 U.S.C. by the Veterans Administration are not RSI benefits.

2. RRB certification

RRB certification is the notification the Railroad Retirement Board (RRB) transmits to the Health Insurance Master Record that an individual has been found to be a qualified Railroad Retirement beneficiary (QRRB).

B. Policy

An individual is entitled to HI beginning with the first month they attained age 65 and:

  • Is receiving benefits from Social Security or the Railroad Retirement Board

  • Is eligible to receive Social Security or Railroad benefits (even if they have not filed an application for monthly benefits) and has filed an application for HI.

  • has been certified by RRB as a QRRB.

NOTE: An individual who dies in the month of attainment of age 65 may be entitled for this month even if death occurs before the actual day of attainment in that month.

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HI 00801.006 - Requirements for Entitlement - Regular Insured Provision - 02/01/2023
Batch run: 02/01/2023