2. All enrollment/disenrollment cases

In all enrollment/disenrollment cases, take the following actions:

• Advise the beneficiary to contact the MA plan for resolution.

• Beneficiaries may also contact 1-800-MEDICARE (1-800-633-4227); (TTY 1-877-486-2048)

• If the beneficiary is unsuccessful and has come into the SSA FO , take a statement from the beneficiary on a Form SSA-795, Statement of Claimant or Other Person explaining the problem. Forward the SSA-795 along with a.screen of the MEQY to the servicing CMS RO. See Center for Medicare and Medicaid Services website for CMS RO email addresses. FAX all documentation, into NDRed.

• If the beneficiary is unsuccessful and has contacted the TSC , take a statement from the beneficiary on Form SSA-5002 Report of explaining the problem. Email the SSA-5002 along with a screen shot of the MEQY to the servicing CMS RO. See Center for Medicare And Medicaid Services website for CMS RO email addresses. After emailing the material, follow local instructions for dispostion of the SSA-5002.

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2. All enrollment/disenrollment cases

Official source

In all enrollment/disenrollment cases, take the following actions:

• Advise the beneficiary to contact the MA plan for resolution.

• Beneficiaries may also contact 1-800-MEDICARE (1-800-633-4227); (TTY 1-877-486-2048)

• If the beneficiary is unsuccessful and has come into the SSA FO , take a statement from the beneficiary on a Form SSA-795, Statement of Claimant or Other Person explaining the problem. Forward the SSA-795 along with a.screen of the MEQY to the servicing CMS RO. See Center for Medicare and Medicaid Services website for CMS RO email addresses. FAX all documentation, into NDRed.

• If the beneficiary is unsuccessful and has contacted the TSC , take a statement from the beneficiary on Form SSA-5002 Report of explaining the problem. Email the SSA-5002 along with a screen shot of the MEQY to the servicing CMS RO. See Center for Medicare And Medicaid Services website for CMS RO email addresses. After emailing the material, follow local instructions for dispostion of the SSA-5002.