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As outlined in § 60.2.1.3, an individual is considered to be temporarily absent from the plan service area when any one or more of the required materials and content referenced in §§ 422.2267(e) and 423.2267(e), if provided by mail, is returned to the plan sponsor by the U.S. Postal Service as undeliverable and a forwarding address is not provided.

60.2.2 – Loss of Medicare Part A, Part B, or Eligibility for Part D 42 CFR §§ 422.50(a)(1), 422.74(b)(2)(ii), 422.74 (d)(5), 423.30(a)(i), 423.44(b)(2)(ii), 423.44(c), and 423.44(d)(3)

As described in § 20, an individual must be entitled to Medicare Part A and enrolled in Medicare Part B, among other criteria, in order to be eligible to elect an MA plan. To be eligible for Medicare Part D, an individual must be entitled to Medicare benefits under Part A or enrolled in Medicare Part B.

An individual is subject to disenrollment from an MA plan when they lose entitlement to Medicare Part A and/or B benefits. The disenrollment effective date is the first day of the calendar month following the last month of entitlement to either Part A or Part B benefits.

An individual is subject to disenrollment from a Part D plan when they lose Part D eligibility. The disenrollment effective date is the first day of the calendar month following the last month of Part D eligibility.

In the case of MA plans:

• CMS will notify the plan when the enrollee’s Part A or B benefits ended (i.e., loss of entitlement) • Plans may provide the enrollee with a notice of disenrollment (MA Exhibit 14) due to the loss of entitlement to either Medicare Part A and/or Part B to correct any erroneous disenrollment.

NOTE: An exception exists for Medicare Part B-only grandfathered members (as described in § 20.2.1) since these members initially enrolled in a § 1876 risk sharing plan, continue enrollment in an MA plan despite not being entitled to Medicare Part A or living in the plan’s service area or continuation area.

In the case of Part D plans: • CMS will notify the plan when the enrollee’s Part D eligibility ended. • Plans may provide the enrollee with a notice of disenrollment (Part D Exhibit 14) due to the loss of entitlement to either Medicare Part A and/or Part B to correct any erroneous disenrollment.

60.2.3 – Death of the Enrollee 42 CFR §§ 422.74(b)(2)(iii), 422.74(d)(6), 423.44(b)(2)(iii), and 423.44(d)(4)

CMS will notify the plan of the death of an enrollee and subsequently disenroll the individual. The disenrollment is effective the first day of the calendar month following the month of death.