§ 435.551 Applicable individual.
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Title 42—Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS > PART 435—ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA > Subpart F—Categorical Requirements for Eligibility > Community Engagement Requirement
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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.
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