# 42 CFR § 435.551: Applicable individual

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/ecfr-42-435.551

## Section

- **Citation:** 42 CFR § 435.551
- **Heading:** Applicable individual
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** September 22, 2026
- **Source:** Publisher's official text
- **Location:** 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

## 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 CFR § 435.520 § 435.520 Age requirements for the aged.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.520.md)
- [42 CFR § 435.530 § 435.530 Definition of blindness.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.530.md)
- [42 CFR § 435.531 § 435.531 Determinations of blindness.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.531.md)
- [42 CFR § 435.540 § 435.540 Definition of disability.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.540.md)
- [42 CFR § 435.541 § 435.541 Determinations of disability.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.541.md)
- [42 CFR § 435.550 § 435.550 Basis and scope.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.550.md)
- [42 CFR § 435.551 § 435.551 Applicable individual.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.551.md)
- [42 CFR § 435.552 § 435.552 Demonstrating community engagement.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.552.md)
- [42 CFR § 435.553 § 435.553 Mandatory exceptions for certain applicable individuals.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.553.md)
- [42 CFR § 435.554 § 435.554 Specified excluded individuals.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.554.md)
- [42 CFR § 435.555 § 435.555 Optional exception for short-term hardship events.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.555.md)
- [42 CFR § 435.556 § 435.556 Assessing compliance with the community engagement requirement.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.556.md)
- [42 CFR § 435.557 § 435.557 Verifying compliance with or exception or exclusion from the community engagement requirement.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.557.md)
- [42 CFR § 435.558 § 435.558 Noncompliance procedures.](https://www.frixlaw.com/law-library/statutes/ecfr-42-435.558.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/ecfr-42-435.551. Check the current official text before relying on it. Not legal advice.