This transmittal outlines the policies and procedures for adjudicating Medicare Part A (Hospital Insurance, HI) premium reduction requests for aged and disabled individuals who are seeking a premium reduction based on quarters of coverage of a current or former same-sex spouse.
On June 26, 2013, in United States v. Windsor, the Supreme Court ruled that Section 3 of the Defense of Marriage Act (DOMA) is unconstitutional. This means that the Social Security Administration is no longer prevented by DOMA from recognizing same-sex marriages for determining entitlement to or eligibility for Medicare. The Social Security Administration processes eligibility determinations and enrollments in Medicare. In addition to other instructions already released regarding same-sex couples, these instructions provide SSA the ability to make HI premium reduction determinations and process requests.