What is the key condition for Mr. Kelly's eligibility for a PFFS plan?

For Mr. Kelly to be eligible for a Private Fee-for-Service (PFFS) plan, he must live in the service area of that specific plan. PFFS plans are a type of Medicare Advantage plan that allows beneficiaries to receive care from any provider who accepts the plan’s payment terms. However, a fundamental requirement is that Mr. Kelly must reside in the geographic area that the PFFS plan serves. This ensures that he can access the medical services and providers available under the plan.

Other conditions, such as age or the specific type of care needed, do not determine eligibility for enrolling in a PFFS plan. For example, there are no age restrictions that would make being under 65 a barrier, nor does needing only urgent care services limit access to enrollment. Furthermore, having zero Medicare Part B benefits is not a requirement for PFFS eligibility – rather, beneficiaries must have both Medicare Part A and Part B to qualify for any Medicare Advantage plans, including PFFS. Thus, residing within the designated service area is the critical factor for Mr. Kelly's eligibility.