[Code of Federal Regulations]
[Title 20, Volume 2]
[Revised as of April 1, 2006]
From the U.S. Government Printing Office via GPO Access
[CITE: 20CFR418]

[Page 1183-1184]
 
                      TITLE 20--EMPLOYEES' BENEFITS
 
               CHAPTER III--SOCIAL SECURITY ADMINISTRATION
 
PART 418_MEDICARE SUBSIDIES--Table of Contents
 
                   Subpart D_Medicare Part D Subsidies
 
Sec.  418.3125  What are redeterminations?

    (a) Redeterminations defined. A redetermination is a periodic review 
of your eligibility to make sure that you are still eligible for a 
subsidy and if so, to determine whether you should continue to receive a 
full or partial subsidy. This review deals with evaluating your income 
and resources (and those of your spouse, who lives with you) and will 
not affect past months of eligibility. It will be used to determine your 
future subsidy eligibility and whether you should receive a full or 
partial subsidy for future months. We will redetermine your eligibility 
if we made the initial determination of your eligibility or if you are 
deemed eligible because you receive SSI benefits. Rules regarding 
redeterminations of initial eligibility determinations made by a State 
are described in 42 CFR 423.774.

[[Page 1184]]

    (b) When we make redeterminations. (1) We will redetermine your 
subsidy eligibility within one year after we determine that you are 
eligible for the subsidy.
    (2) After the first redetermination, we will redetermine your 
subsidy eligibility at intervals determined by the Commissioner. The 
length of time between redeterminations varies depending on the 
likelihood that your situation may change in a way that affects your 
eligibility and whether you should receive a full or partial subsidy.
    (3) We may also redetermine your eligibility and whether you should 
receive a full or partial subsidy when you tell us of a change in your 
circumstances described in Sec.  418.3120.
    (4) We may redetermine your eligibility when we receive information 
from you or from data exchanges with Federal and State agencies that may 
affect whether you should receive a full or partial subsidy or your 
eligibility for the subsidy.
    (5) We will also redetermine eligibility on a random sample of cases 
for quality assurance purposes. For each collection of sample cases, all 
factors affecting eligibility and/or whether you should receive a full 
or partial subsidy may be verified by contact with primary repositories 
of information relevant to each individual factor (e.g., we may contact 
employers to verify wage information). Consequently, we may contact a 
variety of other sources, in addition to recontacting you, to verify the 
completeness and accuracy of our information.

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