# 42 C.F.R. § 435.551 (2026): Applicable individual

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_551

## Section

- **Citation:** 42 C.F.R. § 435.551 (2026)
- **Heading:** Applicable individual
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Title 42 CFR: Public Health / Chapter IV / Part 435 / Subpart F / § 435.551: § 435.551   Applicable individual.

## Text

An applicable individual is an individual who is not a specified excluded individual as defined at § 435.554 and who is— (a) Eligible to enroll or is enrolled under the State plan under § 435.119; or (b) Otherwise eligible to enroll or is enrolled in a demonstration project under section 1115(a)(2) of the Act that provides coverage that meets minimum essential coverage requirements as defined under § 435.4, and who is: (1) At least 19 and under 65 years of age; (2) Not pregnant; (3) Not entitled to or enrolled for benefits under part A of title XVIII or enrolled for benefits under part B of title XVIII; and (4) Not otherwise eligible to enroll under the State plan.

## Nearby sections

- [42 C.F.R. § 435.500 (2026) § 435.500   Scope.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_500.md)
- [42 C.F.R. § 435.520 (2026) § 435.520   Age requirements for the aged.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_520.md)
- [42 C.F.R. § 435.530 (2026) § 435.530   Definition of blindness.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_530.md)
- [42 C.F.R. § 435.531 (2026) § 435.531   Determinations of blindness.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_531.md)
- [42 C.F.R. § 435.540 (2026) § 435.540   Definition of disability.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_540.md)
- [42 C.F.R. § 435.541 (2026) § 435.541   Determinations of disability.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_541.md)
- [42 C.F.R. § 435.550 (2026) § 435.550   Basis and scope.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_550.md)
- [42 C.F.R. § 435.551 (2026) § 435.551   Applicable individual.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_551.md)
- [42 C.F.R. § 435.552 (2026) § 435.552   Demonstrating community engagement.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_552.md)
- [42 C.F.R. § 435.553 (2026) § 435.553   Mandatory exceptions for certain applicable individuals.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_553.md)
- [42 C.F.R. § 435.554 (2026) § 435.554   Specified excluded individuals.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_554.md)
- [42 C.F.R. § 435.555 (2026) § 435.555   Optional exception for short-term hardship events.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_555.md)
- [42 C.F.R. § 435.556 (2026) § 435.556   Assessing compliance with the community engagement requirement.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_556.md)
- [42 C.F.R. § 435.557 (2026) § 435.557   Verifying compliance with or exception or exclusion from the community engagement requirement.](https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_557.md)

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/CFR_T42_P435_S435_551. Check the current official text before relying on it. Not legal advice.