applicable beneficiary

(1) Applicable beneficiary The term “applicable beneficiary” means an individual who, on the date of dispensing a covered part D drug— (A) is enrolled in a prescription drug plan or an MA–PD plan; (B) is not enrolled in a qualified retiree prescription drug plan; (C) is not entitled to an income-related subsidy under section 1395w–114(a) of this title ; and (D) who— (i) has reached or exceeded the initial coverage limit under section 1395w–102(b)(3) of this title during the year; and (ii) has not incurred costs for covered part D drugs in the year equal to the annual out-of-pocket threshold specified in section 1395w–102(b)(4)(B) of this title .

Source

42 USC § 1395w-114a(g)(1)


Scoping language

None identified. Default scope is assumed to be the entire title.
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