Good Cause
True
False
GC4
The enrollee does not qualify for a Good Cause plan change at this time.
GC9
GC1620
GC9
GC1623
GC7
The enrollee does not qualify for a Good Cause plan change at this time.
True
False
GC4
GC9
The enrollee does not qualify for a Good Cause plan change at this time.
GC1621
An additional 60 day change period will be granted.
An additional 120 day change period will be granted.
The enrollee will be locked in to the new plan.
An additional 90 day change period will be granted.
Advise the enrollee of their lock-in and open enrollment dates and tell them to call back to change when they are in their open enrollment period. Offer to file a complaint and include detailed notes.
Submit the plan change request in the discrepancy log since the enrollee has a good reason to change the plan.
Process another GC9 plan change and add that the enrollee is terminally ill so the request will not be denied.
Refer the caller to AHCA to find out why the GC9 was denied since it's not the caller's fault the PCP is not taking the plan anymore.
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