You are eligible to enroll in an Medicare Advantage plan if you permanently reside in the service area (where the plan has doctors and hospitals signed up) of the plan. Vacations or temporary moves do not count. (CMS 20.3) blue shield EOC CMS allows each State to determine the rules for residency in their state.
- to dwell permanently or continuously : occupy a place as one's legal domicile Webster *
- the act or fact of dwelling in a place for some time
- the place where one actually lives as distinguished from one's domicile or a place of temporary sojourn Webster *
- When the plain meaning of a word lends itself to only one reasonable interpretation, that interpretation controls Guide to Contract Interpretation *
Blue Shield Individual & Family
EOC Evidence of Coverage
- Am I a resident?
- Do I need to file?
- Filing requirements
- What form to file
- Community property
Medicare Advantage Plans or Supplement may cancel you when you move out of their service area for more than six months. (Freedom Blue EOC) Check out the rules to keep your current coverage for up to one year. §20.3
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Members Who Change Residence
MA organizations may offer (or continue to offer) extended “visitor” or “traveler” programs to members of coordinated care plans who have been out of the service area for up to 12 months. The MA organizations that offer such programs do not have to disenroll members in these extended programs who remain out of the service area for more than 6 months but less than 12 months. …Organizations offering MA-PFFS plans may allow continued enrollment of individuals absent from the plan service area for up to 12 months,…50.2.1
MA organizations offering plans without these programs must disenroll members who have been out of the service area for more than 6 months.
When you move within a state, state to state or return to USA, you are entitled to a SEP (Special Enrollment Period) where you may choose another Medi Gap or Advantage plan, with NO MEDICAL QUESTIONS. 50.2.1
Enrollment Periods Publication # 11219 Page 7
Email us [email protected] or navigate this website with your specific questions & proposals if moving to or from CA.
Links & Resources
Enrollment Dates for MAPD – Medicare Advantage Moving – change residency counts
See our webpage on lawful presence & public charge
- A California resident is one who is in California for other than a temporary or transitory purpose; or Domiciled in California, but outside California for a temporary or transitory purpose. (ftb.ca.gov).
- Amount of time you spend in California versus amount of time you spend outside California;
- Location of your spouse and children;
- Location of your principal residence;
- Where your driver's license was issued;
- Where your vehicles are registered;
- Where you maintain your professional licenses;
- Where you are registered to vote;
- Location of the banks where you maintain accounts;
- Location of your doctors, dentists, accountants, and attorneys;
- Location of the church, temple or mosque, professional associations, or social and country clubs of which you are a member;
- Location of your real property and investments;
- Permanence of your work assignments in California; and
- Location of your social ties.
In using these factors, it is the strength of your ties and closest connections not just the number of ties, that determines your residency (ftb.ca.gov/)
http://sanjivcpa.com to learn about various tax rules in California. Sanjiv Gupta CPA reviews rules related to residency in California.
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