§ 418.3110. What happens when you apply for a subsidy?
305 words·~1 min read·
/us/cfr/t20/s§ 418.3110·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(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.