US · guidance
CMS Pub. 100-16, ch. mc86c17d, § 20.1
Conversion Enrollments
The cost plan must accept as a Medicare member any individual who was enrolled in the
organization during the month immediately before the month in which he or she became
entitled to both Medicare Parts A and B, or Part B only. The application of this provision
to individuals with ESRD is discussed in §20.2.2.
The cost plan has the option to also allow individuals who are newly entitled to Medicare
Parts A and/or B to elect the cost plan upon conversion even if they reside outside the
service area. The cost plan must apply its choice of this option consistently for all
individuals. These members will be known as “out-of-area” members. This option applies
both to individual members and employer group members of the cost plan.
History
(Rev. 38, 10-31-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7dd20a0c9d4f06837b68d64708ef3899a29699239f2f4d9ec0d8cab7c69bd9e2
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