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• Part C Policy: Enrollee permanently moves out of the continuation area of an MA local plan and their new residence is not in the service area or another continuation area of the MA local plan; • Part C Policy: Enrollee permanently moves out of the service area (or continuation area, for continuation of enrollment enrollees in MA local plans) and into a continuation area, but chooses not to continue enrollment in the MA local plan (refer to § 70.7 for procedures for choosing the continuation of enrollment option); or • Enrollee is incarcerated and, therefore, resides out of area for the duration of the incarceration.

With the exception of incarcerated individuals (see § 60.2.1.1), the disenrollment effective date for the above scenarios is the first day of the calendar month after the date the enrollee permanently leaves the plan’s service area (or continuation area (Part C), as appropriate) AND after the individual or the individual’s authorized representative notifies the plan that they have moved and no longer reside in the plan service area. If the enrollee provides advance notice of the move, the disenrollment occurs the first of the month following the month in which the individual indicates they will be moving.

If the enrollee establishes that a permanent move occurred in the past and requests retroactive disenrollment (not earlier than the first of the month after the move), the plan can submit this request to CMS (or its designee) for consideration of retroactive action.

Individuals who are disenrolled due to a change in residence may use the SEP described in 42 CFR § 422.62(b)(2) and 423.38(c)(7) (see also § 30.6.20) and select another MA or Part D plan in a service area that includes the individual’s new residence. Any disenrollment from an MA plan processed under these provisions will result in a change to enrollment in Original Medicare unless the enrollee elects another MA plan during an applicable election period.

60.2.1.1 – Incarcerated Individuals 42 CFR §§ 422.74(d)(4)(v), 423.44(d)(5)(iii), and 423.44(d)(5)(iv)

In the case of incarcerated individuals, CMS will involuntarily disenroll incarcerated individuals based on data CMS receives from SSA. CMS will report the disenrollments to the plan via the DTRR providing TRC 346 Disenrollment due to Confirmed Incarceration.

When CMS notifies the plan of the disenrollment due to an enrollee’s incarceration status, the disenrollment effective date is the first of the month after the incarceration start date, including for retroactive periods of incarceration.

When a plan receives an enrollee’s incarceration status from a source other than CMS, an investigation is required to determine whether the individual is incarcerated. Confirmation may include contacting the individual or other sources to determine current incarceration status and incarceration start and end dates, if applicable.

If the plan confirms the enrollee is currently incarcerated but does not obtain the start date of the current incarceration, the plan must involuntarily disenroll the individual prospectively for the