The Totalization provisions of all U.S. agreements apply to U.S. retirement, survivors and disability insurance (RSDI) benefits but not to special age-72 payments or transitionally insured benefits. Thus, U.S. quarters of coverage (QCs) can be combined with periods of foreign coverage to establish fully insured status, disability insured status and currently insured status but not the insured status required for special age-72 payments or transitionally insured benefits.

The same factors of entitlement that apply to regular (non-Totalization) benefits also apply to Totalization benefits.

Neither Medicare nor Supplemental Security Income (SSI) benefits are included in Totalization agreements. However, a beneficiary entitled to Totalization benefits may simultaneously qualify for Medicare or SSI if the beneficiary meets the requirements independently of an agreement.

A person age 65 is entitled to “A” benefits on as a result of a Totalization agreement. This same person is also entitled to “B” benefits on the record of a spouse who is insured based on U.S. coverage alone. While the person cannot be entitled to premium-free hospital insurance (HI) based on entitlement to the “A” benefit because it is a Totalization benefit (see GN 01701.140), the person can be entitled to premium-free HI based on entitlement to the “B” benefit since it is not a Totalization benefit.