Medicare Ethics and Compliance Practice Test 2026 – Your All-in-One Guide to Exam Success!

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In which situation is a Medicare Advantage member involuntarily disenrolled from their MA plan?

The member moves outside the service area.

The member misses a premium payment.

The member changes PCP within plan.

Disenrollment from a Medicare Advantage plan happens when a member can no longer meet the plan’s eligibility or coverage area requirements. The clearest example is moving to a location outside the plan’s service area—the plan can’t cover you there, so your enrollment in that MA plan ends and you’d need to join a plan in the new area or switch to Original Medicare.

Changing a PCP within the plan is not disenrollment; you stay enrolled in the same MA plan and simply switch providers within the network. Attending orientation doesn’t affect enrollment. Missing a premium payment can lead to disenrollment, but that depends on the plan’s payment grace period and CMS rules, so it’s a separate, administrative trigger rather than a geographic one.

The member attends orientation.

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