Medicare Eligibility File Comparison Chart

Center for Medicare & Medicaid Services
December 2018

The Medicare Eligibility File Comparison Chart compares the source and timing of data CMS provides to states via various on-going and ad hoc file exchanges. All provide advance notice of Medicare eligibility, so can be used by the states to identify for their plans those in their Medicaid MCOs who are about to become Medicare eligible. Only once the State Medicaid Agency Contract includes provisions indicating the state approves the use of default enrollment and when the state agrees to provide the plan with advance notice of Medicaid MCO enrollees who have upcoming Medicare eligibility, can D-SNPs then apply to CMS to conduct default enrollment.