42 CFR §417.422
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
Except as specified in §§ 417.423 and 417.424, an HMO or CMP must enroll, either for an indefinite period or for a specified period of at least 12 months, any individual who meets all of the following:
- (a)Is entitled to Medicare benefits under Parts A and B or under Part B only.
- (b)Lives within the geographic area served by the HMO or CMP.
- (c)Is not enrolled in any other HMO or CMP that has entered into a contract under subpart L of this part.
- (d)During an enrollment period of the HMO or CMP, completes the HMO's or CMP's application form or another CMS-approved election mechanism and gives whatever information is required for enrollment.
- (e)Agrees to abide by the HMO's or CMP's rules after they are disclosed to him or her in connection with the enrollment process.
- (f)Is not denied enrollment by the HMO or CMP under a selection policy, if any, that has been approved by CMS under § 417.424(b).
- (g)Is not denied enrollment by the HMO or CMP on the basis of any of the administrative criteria concerning denial of enrollment in § 417.424(a).
- (h)Is a United States citizen or an individual who is lawfully present in the United States as determined in 8 CFR 1.3.