Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Part B – Non Entitlement Reason Codes
The following codes occur when there is no Part B Entitlement Date and no Part B
Termination Date:
Code
D
N
R
Definition
Coverage denied
No Foreign/Puerto Rican Beneficiary is not entitled to SMI or dually/Technically entitled
Beneficiary ID not entitled to SMI.
Refused benefits
Part B - Enrollment Reason Codes
Code
B
C
D
F
G
I
K
M
R
S
T
U
Definition
Equitable Relief
Good Cause
Deemed date of birth
Working aged
General enrollment period
Initial enrollment period
Renal disease was a reason for entitlement prior to age 65 or prior to the 25 th month of disability
Renal entitlement terminated, but disability based entitlement continues
Residency requirements are involved
State buy-in
Disabled working Individual *
* = future – current CMS program edits do not create this code
Unknown
December 28, 2012 I-107 Entitlement Status and
Enrollment Reason Codes