Medicare Advantage and Prescription Drug Plans December 28 ...

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