within an age cohort is enrolled in the voucher program, the Secretary shall provide a voucher to such individual in an amount that is equal to the monthly actuarial rate for that month computed under section 1818(d)(1) multiplied by the age cohort adjustment factor for such age cohort under subparagraph (B). (ii) Monthly limit The amount of a voucher provided to an individual for a month may not exceed $200. (B) Age cohort adjustment factor For each age cohort the Secretary shall determine an age cohort adjustment factor equal to the ratio of— (i) the monthly actuarial rate described in section 1818(d)(1) as determined by the Secretary for individuals in such age cohort, to (ii) the monthly actuarial rate described in such section. (C) Age cohort defined For purposes of this paragraph, an age cohort means a group of individuals whose age falls within a span of five consecutive years, consistent with the following: (i) The first such span begins at age 65. (ii) Other spans follow consecutively. (4) Permissible use of voucher A voucher under paragraph (3) may be used only for the following purposes: (A) As a contribution into a health savings account established by such individual, as described in subsection (k)(1)(A). (B) For payment of premiums for enrollment of such individual under a high deductible health plan described in such subsection. (5) Effect of subsequent termination of waiver If an individual terminates a waiver under subsection (k)(4), the enrollment of such individual in the voucher program shall be terminated on the date on which the termination becomes effective. . (b) Amendment of Internal Revenue Code of 1986 Paragraph (7) of section 223(b) of the Internal Revenue Code of 1986 (relating to Medicare eligible individuals) is amended to read as follows: (7) Medicare eligible individuals (A) In general The limitation under this subsection for any month with respect to an individual shall be zero for any month such individual is entitled to benefits under title XVIII of the Social Security Act.