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20 – Eligibility for Enrollment in MA and Part D Plans 42 CFR §§ 422.50, 423.30, and 423.32

To enroll in an MA or Part D plan the individual must:

MA plan Part D plan Be eligible to enroll in an MA plan by having Part A and Part B* Be eligible to enroll in a Part D plan by having either Part A or Part B, or both Permanently reside within the plan’s service area* Be a United States citizen or be lawfully present in the U.S. Complete an enrollment request (as outlined in § 20.5)* Agree to abide by the rules of the plan Submit the enrollment request to the plan during a valid enrollment period* Meet additional requirements outlined in § 20.8 to elect hospice or enroll in Religious Fraternal Benefit (RFB), Medicare Medical Savings Account (MSA) plan or a Special Needs Plan (SNP) N/A *Limited exceptions apply.

Plans may not impose any additional eligibility requirements as a condition of enrollment other than those in the applicable regulations and outlined by CMS in this guidance.

Plans must also abide by the following: • Plans may not deny enrollment to individuals based on other coverage under an employer/union-sponsored group health plan, provided they meet the eligibility requirements outlined. • If the individual is enrolled in a qualified retiree drug plan that receives the retiree drug subsidy (RDS), the individual’s status as a qualifying covered retiree will terminate.

20.1 – Simultaneous Enrollment in MA and Part D Social Security Act §§ 1852 and 1857(i); 42 CFR §§ 422.50(b), 423.30(a)(2)(iii), (b), (d), and 423.104(f)(4)(i)

There are limits on the types of Part C and Part D plans that individuals may be enrolled in at the same time. Individuals may not be enrolled in more than one MA plan or more than one Part D plan at the same time. Additionally, with limited exceptions, an individual cannot be enrolled in both an MA plan and a stand-alone PDP.