Question

Mr. Wilcox has been enrolled in Lexington PFFS Medicare Advantage Health Plan (Lexington) for several years. Recently, Mr. Wilcox decided to spend time with his children who live in another state that is not in Lexington's service area. In the future, he may relocate near his children permanently. How does this move to another service area impact his PFFS MA coverage?
Choose one answer.

a. Lexington can allow for Mr. Wilcox’s continued enrollment for up to 12 months whether or not he is in a visitor/traveler (V/T) program.

b. Lexington must disenroll Mr. Wilcox after 12 weeks unless he can provide proof that he is simply visiting on a temporary basis.

c. Lexington can offer an extended visitor/traveler (V/T) benefit to Mr. Wilcox for up to 15 months.

d. Lexington must disenroll Mr. Wilcox after 6 months unless he can provide proof that he is simply visiting on a temporary basis.


HELP with answer PLEASE ?

Answer 1

Answer:

a. Lexington can allow for Mr. Wilcox’s continued enrolment for up to 12 months whether or not he is in a visitor/traveller (V/T) program.

Explanation:

Private - Fee - For - Similar Plans is much similar like the original medicare plans. This is provided through a private health insurance company.

In the given instance, Mr. Wilcox plans to relocate near his children, who live in some other state.

As he will move to another service area, he shall simply not be disabled to claim the benefits of PFFS. Further, the insurance company can still cover him for another 12 months, even if he does not choose to visit the current service area as traveller in upcoming 12 months.