StacksVerified U.S. regulatory reference

20 CFR §418.3110

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov
  1. (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.
  2. (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. (1)You are eligible for a full or partial subsidy for a period not to exceed 1 year;
    2. (2)What information we used to make this determination including how we calculated your income and resources;
    3. (3)What you may do if your circumstances change as described in § 418.3120; and
    4. (4)Your appeal rights.
  3. (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.
  4. (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. (1)You are not eligible for a subsidy;
    2. (2)The information we used to make this determination including how we calculated your income or resources;
    3. (3)You may reapply if your situation changes; and
    4. (4)Your appeal rights.