TN 31 (06-04)
HI 00801.143 Evidence of Enrollment in A Medicare Managed Care Plan
In all cases of enrollment or premium surcharge relief under the transfer enrollment period provisions, it is necessary to verify that the individual is or was enrolled in an MMCP that meets the requirements in HI 00208.066C.2. and HI 00208.066.D.
Enrollment in an MMCP can be verified by checking the Medicare Enrollment Query (MEQY) on the HI/SMI Query Response (HIQR) Screen (see MSOM QUERIES 008.001). The dates of enrollment and disenrollment can also be obtained from the MEQY. If termination information is not shown, assume that the individual is still enrolled in the MMCP.
If there is no enrollment information on the MEQY or a discrepancy in the dates shown, contact the appropriate CMS Regional Office (see HI 00801.143C.) for assistance in obtaining the necessary evidence.
C. CMS Regional offices
Region I (Boston)
Region IV (Atlanta)
Region VII (Kansas City)
Region X (Seattle)
Region II (New York)
Region V (Chicago)
(312) 353-5737 email@example.com
Region VIII (Denver)
(303) 844-1568 firstname.lastname@example.org
Region III (Philadelphia)
Region VI (Dallas)
(214) 767-6401 email@example.com
Region IX (San Francisco)
(415) 744-3617 firstname.lastname@example.org