If Mr. White moves to another service area, how does this affect his PFFS MA coverage?

Study for the AHIP Training Test. Engage with flashcards and multiple-choice questions, each question comes with hints and explanations. Get ready for your exam!

When Mr. White moves to another service area, the rules governing a Private Fee-for-Service (PFFS) Medicare Advantage (MA) plan provide specific guidelines about the transition. One of the key features of PFFS plans is that they generally offer flexibility when it comes to geographic coverage.

If he moves, he has the option to remain enrolled in his existing PFFS plan for a period of up to 12 months, during which time he can continue to receive his benefits as outlined by the plan. This is designed to accommodate beneficiaries who may take time to adjust to their new circumstances and consider their options for healthcare coverage.

After the 12-month period, he would need to explore other options, which may involve re-evaluating his coverage based in the new area. This transitional period allows for continuity of care and protection against immediate loss of coverage that might occur if the move resulted in a gap in available services or plan requirements.

The other answer choices do not reflect the accurate procedures in this scenario since coverage is not immediately terminated, he is not required to apply for a new plan right away, and switching to a Medicare Supplement plan isn’t a mandatory requirement because PFFS plans differ from Supplement plans in terms of coverage and enrollment

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