---
kind: "range"
citation: "20 C.F.R. §§ 418.3501–418.3515"
title: "20"
from: "418.3501"
to: "418.3515"
count: 4
url: "https://uscodex.org/cfr/20/418.3501..418.3515"
---

# §418.3501. What could cause us to increase or reduce your subsidy or terminate your subsidy eligibility?

- (a) Certain changes in your circumstances could cause us to increase or reduce your subsidy or terminate your subsidy eligibility. These changes include (but are not limited to) changes to:
  - (1) Your income;
  - (2) Your spouse's income if you are married and living with your spouse;
  - (3) Your resources;
  - (4) Your spouse's resources if you are married and living with your spouse; and
  - (5) **Your family size.**
- (b) We will periodically review your circumstances (as described in [§ 418.3125](/cfr/20/418.3125.md)) to make sure you are still eligible for a subsidy and, if eligible, whether you should receive a full or partial subsidy.
- (c) If you report that your circumstances have changed or we receive other notice of such a change after we determine that you are eligible, we will review your circumstances as described in [§ 418.3120](/cfr/20/418.3120.md) to determine if you are still eligible.

# §418.3505. How would an increase, reduction or termination affect you?

- (a) An increase in your subsidy means that you would be able to pay a lower premium to participate in the Medicare Part D prescription drug program. An increased subsidy may also result in a reduction in any deductible or copayments for which you are responsible.
- (b) A reduction in your subsidy means that you would have to begin to pay a premium or a higher premium to participate in the Medicare Part D prescription drug program. You may also have to begin to pay a deductible and higher copayments or increase the amounts of these payments.
- (c) A termination means that you would no longer be eligible for a subsidy under the Medicare Part D prescription drug program.

# §418.3510. When would an increase, reduction or termination start?


We are required to give you a written notice of our proposed action before increasing, reducing, or terminating your subsidy. We will not give this advance notice where we have factual information confirming your death, such as through a report by your surviving spouse, a legal guardian, a close relative, or a landlord. The notice will tell you the first month that we plan to make the change. The notice will also give you appeal rights which are explained in detail in [§§ 418.3601 through 418.3670](/cfr/20/418.3601..418.3670.md). Your appeal rights for a reduction or termination will include the right to continue to receive your subsidy at the previously established level until there is a decision on your appeal request if your appeal is filed within 10 days after you receive our notice. You will not be required to pay back any subsidy you received while your appeal was pending.


# §418.3515. How could you qualify for a subsidy again?


Unless you subsequently qualify as a deemed eligible person (per [42 CFR 423.773(c)](/cfr/42/423.773.md?p=c)), you must file a new application for a subsidy and meet all the requirements in [§ 418.3101](/cfr/20/418.3101.md).