Medicare Advantage and Prescription Drug Plans December 28 ...

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Plan Communications User Guide Appendices, Version 6.3 I.8 Entitlement Status and Enrollment Reason Codes The tables below list the codes for Part A and Part B Enrollment, Entitlement and Non-Entitlement 1.8.1 Entitlement Status Code Tables Part A – Entitlement Status Codes The following codes occur when the Part A Entitlement Date is present and the Part A Termination Date is blank: Code E G Y Definition Free Part A Entitlement Entitled due to good cause Currently entitled, premium is payable The following codes occur when the Part A Entitlement Date is present and the Part A Termination Date is also present: Code C S T W X Definition No longer entitled due to disability cessation Terminated, no longer entitled under ESRD provision Terminated for non-payment of premiums Voluntary withdrawal from premium Part A coverage Free Part A terminated because of Title II termination Part A – Non Entitlement Status Codes The following codes occur when there is no Part A Entitlement Date and no Part A Termination Date: Code D F H N R Definition Coverage denied Terminated due to invalid enrollment or enrollment voided Ineligible for free Part A, or did not enroll for premium Part A Not valid SSA HIC, used by CMS 3 rd party sys for potential PTA entitled date Refused benefits December 28, 2012 I-105 Entitlement Status and Enrollment Reason Codes
Plan Communications User Guide Appendices, Version 6.3 Part A - Enrollment Reason Codes Code Definition A Attainment of age 65 B Equitable relief Code Definition D Disability – Under age 65 entitlement G General Enrollment Period I Initial Enrollment Period J MQGE entitlement K Renal disease not reason for entitled prior to 65 or 25 th month of disability L Late filing M Termination based on renal entitlement but disability based on entitlement continues N Age 65 and uninsured P Potentially insured beneficiary is enrolled for Medicare coverage only Q Quarters of coverage requirements are involved R Residency requirements are involved T Disabled working individual U Unknown blank = not applicable; e.g. Part A data is generated at age 64 years, 8 months Part B - Entitlement Status Codes The following codes occur when the Part B Entitlement Date is present and the Part B Termination Date is blank: Code G Y Entitled due to good cause Currently entitled, premium is payable Definition The following codes occur when the Part B Entitlement Date is present and the Part B Termination Date is also present: Code C F S T W Definition No longer entitled due to cessation of disability Terminated due to invalid enrollment or enrollment voided Terminated, no longer entitled under ESRD provision Terminated for non-payment of premiums Voluntary withdrawal from coverage December 28, 2012 I-106 Entitlement Status and Enrollment Reason Codes
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Medicare Advantage and Prescription
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Medicare Advantage and Prescription Drug Plans December 28 ...

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