42 CFR § 407.4 - Basic requirements for entitlement.

---
identifier: "/us/cfr/t42/s407.4"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 407.4 - Basic requirements for entitlement."
title_number: 42
title_name: "Public Health"
section_number: "407.4"
section_name: "Basic requirements for entitlement."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "B"
subchapter_name: "MEDICARE PROGRAM"
part_number: "407"
part_name: "SUPPLEMENTARY MEDICAL INSURANCE (SMI) ENROLLMENT AND ENTITLEMENT"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302, 1395p, 1395q, and 1395hh."
regulatory_source: "53 FR 47204, Nov. 22, 1988, unless otherwise noted."
cfr_part: "407"
---


# 407.4 Basic requirements for entitlement.

(a) An individual must meet the following requirements to be entitled to SMI:

(1) *Eligibility.* The individual must meet the eligibility requirements specified in § 407.10(a).

(2) *Enrollment.* The individual must enroll for SMI, or must be enrolled by a State under a buy-in agreement as specified in § 407.40.

(b) SMI pays only for covered expenses incurred during an individual's period of entitlement.