---
kind: "section"
citation: "42 C.F.R. § 417.422"
title: "42"
number: "417.422"
heading: "Eligibility to enroll in an HMO or CMP."
url: "https://uscodex.org/cfr/42/417.422"
---

# §417.422. Eligibility to enroll in an HMO or CMP.


Except as specified in §§ [417.423](/cfr/42/417.423.md) and [417.424](/cfr/42/417.424.md), an HMO or CMP must enroll, either for an indefinite period or for a specified period of at least 12 months, any individual who meets all of the following:

- (a) **Is entitled to Medicare benefits under Parts A and B or under Part B only.**
- (b) **Lives within the geographic area served by the HMO or CMP.**
- (c) **Is not enrolled in any other HMO or CMP that has entered into a contract under subpart L of this part.**
- (d) During an enrollment period of the HMO or CMP, completes the HMO's or CMP's application form or another CMS-approved election mechanism and gives whatever information is required for enrollment.
- (e) Agrees to abide by the HMO's or CMP's rules after they are disclosed to him or her in connection with the enrollment process.
- (f) Is not denied enrollment by the HMO or CMP under a selection policy, if any, that has been approved by CMS under [§ 417.424(b)](/cfr/42/417.424.md?p=b).
- (g) Is not denied enrollment by the HMO or CMP on the basis of any of the administrative criteria concerning denial of enrollment in [§ 417.424(a)](/cfr/42/417.424.md?p=a).
- (h) Is a United States citizen or an individual who is lawfully present in the United States as determined in [8 CFR 1.3](/cfr/8/1.3.md).

## Notes

### Amendments

[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38078, July 15, 1993; 60 FR 45677, Sept. 1, 1995; 77 FR 22166, Apr. 12, 2012; 80 FR 7958, Feb. 12, 2015]

### Source

Source: 50 FR 1346, Jan. 10, 1985, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302 and 1395hh, and 300e, 300e-5, and 300e-9, and 31 U.S.C. 9701.

### Amendments

[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38078, July 15, 1993; 60 FR 45677, Sept. 1, 1995; 77 FR 22166, Apr. 12, 2012; 80 FR 7958, Feb. 12, 2015]