20 C.F.R. § 418.3110

Current through October 31, 2024
Section 418.3110 - What happens when you apply for a subsidy?
(a) When you or your personal representative apply for a subsidy, we will ask for information that we need to determine if you meet all the requirements for a subsidy. You must give us complete information. If, based on the information you present to us, you do not meet all the requirements for eligibility listed in § 418.3101 , or if one of the events listed in § 418.3115 exists, or you fail to submit information we request, we will deny your claim.
(b) If you meet all the requirements for eligibility listed in § 418.3101 , or you meet all the requirements except for enrollment in a Medicare Part D plan or Medicare Advantage plan with prescription drug coverage, we will send you a notice telling you the following:
(1) You are eligible for a full or partial subsidy for a period not to exceed 1 year;
(2) What information we used to make this determination including how we calculated your income and resources;
(3) What you may do if your circumstances change as described in § 418.3120 ; and
(4) Your appeal rights.
(c) If you are not already enrolled with a Medicare prescription drug plan or a Medicare Advantage plan with prescription drug coverage, you must enroll in order to receive your subsidy.
(d) If you do not meet all the requirements for eligibility listed in § 418.3101 or if § 418.3115 applies to you except for enrollment in a Medicare Part D plan or Medicare Advantage plan with prescription drug coverage as described in § 418.3225 , we will send you a notice telling you the following:
(1) You are not eligible for a subsidy;
(2) The information we used to make this determination including how we calculated your income or resources;
(3) You may reapply if your situation changes; and
(4) Your appeal rights.

20 C.F.R. §418.3110