Disenrollment from the Plan
In all instances when your membership ends, you will be given proper notice and an opportunity to challenge the decision related to your disenrollment. Your membership in the Plan may end if:
- You attest to permanently moving outside of our service area or you move out of our service area for more than six months.
- You withhold information about other insurance you have that provides prescription coverage or if you intentionally give us incorrect information when you are enrolling in our Plan and that information affects your eligibility for our Plan.
- You continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our Plan.
- You do not pay the Plan premiums for up to three months. If you need extra help to pay for the costs of your prescription drugs and premiums, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or Your State Medicaid Office.
If you disenroll from our plan, please note the following:
- If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins).
- You have the right to make a complaint if we end your membership in our plan.
- If we end your membership in our plan, we must tell you our reasons in writing for ending your membership.
- We must also explain how you can make a complaint about our decision to end your membership.
For more details about disenrollment, please refer to the section "Ending your membership in the plan" in your Evidence of Coverage (EOC) document.
All Medicare Advantage Plans agree to stay in the program for a full calendar year at a time. Plan benefits and cost-sharing may change from calendar year to calendar year. Each year, plans can decide whether to continue to participate with Medicare Advantage. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue for an additional calendar year, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.
Last Update 10/1/2019