§ 418.3010 - Definitions.


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  • § 418.3010 Definitions.

    (a) Terms relating to the Act and regulations.

    (1) CMS means the Centers for Medicare & Medicaid Services in the Department of Health and Human Services.

    (2) Commissioner means the Commissioner of Social Security.

    (3) Section means a section of the regulations in part 418 of this chapter unless the context indicates otherwise.

    (4) The Act means the Social Security Act, as amended.

    (5) Title means a title of the Act.

    (6) We , our or us means the Social Security Administration (SSA).

    (b) Miscellaneous.

    (1) Claimant means the person who files an application for himself or herself or the person on whose behalf an application is filed.

    (2) Date you receive a notice means 5 calendar days after the date on the notice, unless you show us you did not receive it within the 5-day period.

    (3) Decision means the decision we make after a hearing.

    (4) Determination means the initial determination that we make as defined in § 418.3605.

    (5) Family size , for purposes of this subpart, means family size as defined in 42 CFR 423.772.

    (6) Federal poverty line , for purposes of this subpart, has the same meaning as Federal poverty line in 42 CFR 423.772.

    (7) Full-benefit dual eligible individual for purposes of this subpart, has the same meaning as full-benefit dual eligible individual in 42 CFR 423.772.

    (8) Medicare beneficiary means an individual who is entitled to or enrolled in Medicare Part A (Hospital Insurance) or enrolled in Part B (Supplementary Medical Insurance) or both under title XVIII of the Act.

    (9) Periods of limitations ending on Federal non-workdays Title XVIII of the Act and regulations in this subpart require you to take certain actions within specified time periods or you may lose your right to a portion of or your entire subsidy. If any such period ends on a Saturday, Sunday, Federal legal holiday, or any other day all or part of which is declared to be a nonworkday for Federal employees by statute or Executive Order, you will have until the next Federal workday to take the prescribed action.

    (10) Representative or personal representative means a personal representative as defined in 42 CFR 423.772.

    (11) State, unless otherwise indicated, means:

    (i) A State of the United States; or

    (ii) The District of Columbia.

    (12) Subsidy eligible individual, for purposes of this subpart, has the same meaning as subsidy eligible individual as defined in 42 CFR 423.773.

    (13) Subsidy means an amount CMS will pay on behalf of Medicare beneficiaries who are eligible for a subsidy of their Medicare Part D costs. The amount of a subsidy for a Medicare beneficiary depends on the beneficiary's income as related to household size, resources, and late enrollment penalties (if any) as explained in 42 CFR 423.780 and 42 CFR 423.782. We do not determine the amount of the subsidy, only whether or not the individual is eligible for a full or partial subsidy.

    (14) United States when used in a geographical sense means:

    (i) The 50 States; and

    (ii) The District of Columbia

    (1) You or your means the person who applies for the subsidy, the person for whom an application is filed or anyone who may consider applying for a subsidy.