A Medicare Advance Beneficiary Notice (ABN) is a written notification that a Private Fee-for-Service (PFFS) plan is required to provide to its members prior to discontinuing their coverage. This notice details the reasons for the termination of the member’s coverage and outlines the steps the member needs to take to secure ongoing coverage. Issuance of an ABN is mandatory whenever there are reductions in PFFS offerings, such as a decrease in services covered, or if there is an escalation in the member’s premiums or out-of-pocket expenses. The plan must furnish the member with the ABN at a minimum of 45 days before the suggested date of implementation for these changes. Should a member fail to react to the ABN and the plan terminates a benefit or coverage within the PFFS framework, the member retains the option to choose a different PFFS plan, or to join a Medicare Advantage plan or another Medicare health plan.
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