---
kind: "section"
citation: "42 C.F.R. § 435.909"
title: "42"
number: "435.909"
heading: "Automatic entitlement to Medicaid following a determination of eligibility under other programs."
url: "https://uscodex.org/cfr/42/435.909"
---

# §435.909. Automatic entitlement to Medicaid following a determination of eligibility under other programs.

- (a) **Automatic enrollment of certain individuals in Medicaid.** The agency must not require a separate application for Medicaid from an individual, if the agency has an agreement with the Social Security Administration (SSA) under section 1634 of the Act for determining Medicaid eligibility; and—
  - (1) The individual receives SSI;
  - (2) The individual receives a mandatory State supplement under either a federally-administered or State-administered program; or
  - (3) The individual receives an optional State supplement and the agency provides Medicaid to beneficiaries of optional supplements under [§ 435.230](/cfr/42/435.230.md).
- (b) **Automatic enrollment of SSI recipients in the Qualified Medicare Beneficiary group.**
  - (1) The agency must deem individuals eligible for the Qualified Medicare Beneficiary group as described in [§ 400.200](/cfr/42/400.200.md) of this chapter if the individual receives SSI and is determined eligible for medical assistance under [§ 435.120](/cfr/42/435.120.md) or [§ 435.121](/cfr/42/435.121.md); and—
    - (i) The individual is entitled to Part A under [part 406](/cfr/42/part406.md), [subpart B](/cfr/42/subpartB.md), of this chapter; or
    - (ii) The individual is entitled to Part A under [§ 406.20](/cfr/42/406.20.md) of this chapter and the agency has a State buy-in agreement authorized under section 1843 of the Act and modified under [section 1818(g)](/cfr/42/1818.md?p=g) of the Act.
  - (2) The agency may deem individuals eligible for the Qualified Medicare Beneficiary group as described in [§ 400.200](/cfr/42/400.200.md) of this chapter if the individual receives SSI and is determined eligible for medical assistance under §§ [435.120](/cfr/42/435.120.md) or [435.121](/cfr/42/435.121.md); and—
    - (i) The individual is entitled to Part A under [§ 406.5(b)](/cfr/42/406.5.md?p=b) of this chapter; and
    - (ii) The agency uses the group payer arrangement under [§ 406.32(g)](/cfr/42/406.32.md?p=g) of this chapter to pay Part A premiums for Qualified Medicare Beneficiaries.
  - (3) The automatic enrollment of SSI recipients in the Qualified Medicare Beneficiaries group described in paragraphs [(b)(1)](#b-1) and [(2)](#b-2) of this section is effective no earlier than the effective date of coverage under a buy-in agreement for individuals described in [§ 407.47(b)](/cfr/42/407.47.md?p=b) of this chapter.

## Notes

### Amendments

[88 FR 65270, Sept. 21, 2023]

### Source

Source: 44 FR 17937, Mar. 23, 1979, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45204, Sept. 29, 1978, unless otherwise noted.

### Amendments

[88 FR 65270, Sept. 21, 2023]