42 U.S.C. § 1395b: Option to individuals to obtain other health insurance protection

Nothing contained in this subchapter shall be construed to preclude any State from providing, or any individual from purchasing or otherwise securing, protection against the cost of any health services. For purposes of title II of the Social Security Act [ 42 U.S.C. 401 et seq.] and chapter 21 of the Internal Revenue Code of 1986 [ 26 U.S.C. 3101 et seq.], the term ‘wages’ shall not include the amount of any refund required under section 421 of the Medicare Catastrophic Coverage Act of 1988 [ section 421 of Pub. L. 100–360 , formerly set out as a note below]. For purposes of chapter 22 of the Internal Revenue Code of 1986 [ 26 U.S.C. 3201 et seq.], the term ‘compensation’ shall not include the amount of any refund required under section 421 of the Medicare Catastrophic Coverage Act of 1988. For purposes of chapter 23 of the Internal Revenue Code of 1986 [ 26 U.S.C. 3301 et seq.], the term ‘wages’ shall not include the amount of any refund required under section 421 of the Medicare Catastrophic Coverage Act of 1988. For purposes of the Railroad Unemployment Insurance Act [ 45 U.S.C. 351 et seq.], the term ‘compensation’ shall not include the amount of any refund required under section 421 of the Medicare Catastrophic Coverage Act of 1988. For purposes of chapter 23A of the Internal Revenue Code of 1986 [ 26 U.S.C. 3321 et seq.], the term ‘rail wages’ shall not include the amount of any refund required under section 421 of the Medicare Catastrophic Coverage Act of 1988. Any refund required under section 421 of the Medicare Catastrophic Coverage Act of 1988 shall be reported to the Secretary of the Treasury or his delegate and to the person to whom such refund is made in such manner as the Secretary of the Treasury or his delegate shall prescribe. This section shall apply with respect to refunds provided on or after January 1, 1989 .”