Final answer:
Involuntary disenrollment from a Medicare Advantage plan can happen due to non-payment of premiums, violation of plan rules, entering a long-term care facility, or moving out of the plan's service area.
Step-by-step explanation:
Involuntary disenrollment from a Medicare Advantage plan can occur for several reasons:
- Non-payment of premiums: If a member does not pay their premiums on time, the plan has the right to disenroll them.
- Violation of plan rules: If a member violates the rules of their Medicare Advantage plan, such as using out-of-network providers without prior authorization, the plan may disenroll them.
- Entering a long-term care facility: If a member enters a long-term care facility, such as a nursing home, for more than 90 days, they will be automatically disenrolled from their Medicare Advantage plan.
- Moving out of the plan's service area: If a member moves out of the service area covered by their Medicare Advantage plan, they will need to find a new plan that covers their new location.