What essential information do you need from Mr. Anderson to determine his eligibility for a PFFS plan?

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To determine Mr. Anderson's eligibility for a Private Fee-for-Service (PFFS) plan, it is crucial to establish whether he is entitled to Medicare Part A and is enrolled in Part B. PFFS plans are Medicare Advantage plans, which require beneficiaries to have both Parts A and B to qualify for coverage.

Part A generally covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care, while Part B covers outpatient care, preventive services, and other medical services. Without entitlement to these parts, Mr. Anderson would not be eligible for a PFFS plan, as these are designed specifically for individuals who are already enrolled in Medicare.

Other options such as previous income records, past insurance claims, and age/residency, while possibly relevant in other contexts, do not directly address the foundational eligibility criteria for enrollment in a PFFS plan. The primary focus must be on his Medicare enrollment status.

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