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Member Disenrollment Rights and Responsibilities

You are entitled to important rights as a member of our health insurance plan.

Disenrollment Rights

You may end your membership in our plan only during certain times of the year, known as election periods. All members have the opportunity to leave the plan during the Annual Election Period and during the annual Medicare Advantage Disenrollment Period. In certain situations, you may also be eligible to leave the plan at other times of the year.

Annual Election Period

You can end your membership during the Annual Election Period. This is the time when you should review your health and drug coverage and make a decision about your coverage for the upcoming year.

  • When is the Annual Election Period? This happens from October 15 to December 7.
  • What type of plan can you switch to during the Annual Election Period? During this time, you can review your health coverage and your prescription drug coverage.

You can choose to keep your current coverage or make changes to any of the following types of plans:

  • Another Medicare health plan. (You can choose a plan that covers prescription drugs or one that does not cover prescription drugs.)
  • Original Medicare with a separate Medicare prescription drug plan.
  • – or – Original Medicare without a separate Medicare prescription drug plan.
  • If you receive Extra Help from Medicare to pay for your prescription drugs: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you have opted out of automatic enrollment.

Note: If you disenroll from Medicare prescription drug coverage and go without creditable prescription drug coverage, you may need to pay a late enrollment penalty if you join a Medicare drug plan later. (“Creditable” coverage means the coverage is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.)

  • When will your membership end? Your membership will end when your new plan’s coverage begins on January 1.

 

Medicare Advantage Open Enrollment Period

You have the opportunity to make one change to your health coverage during the annual Medicare Advantage Open Enrollment Period.

  • When is the annual Medicare Advantage Open Enrollment Period? This happens every year from January 1 to March 31.
  • What type of plan can you switch to during the annual Medicare Advantage Open Enrollment Period? During this time, you can cancel your Medicare Advantage Plan enrollment and switch to:
  • Another Medicare health plan. (You can choose a plan that covers prescription drugs or one that does not cover prescription drugs.)
  • Original Medicare with a separate Medicare prescription drug plan.
  • – or – Original Medicare without a separate Medicare prescription drug plan.
    If you receive Extra Help from Medicare to pay for your prescription drugs: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you have opted out of automatic enrollment.

Note: If you disenroll from Medicare prescription drug coverage and go without creditable prescription drug coverage, you may need to pay a late enrollment penalty if you join a Medicare drug plan later. (“Creditable” coverage means the coverage is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.)

  • When will your membership end? Your membership will end on the first day of the month after we get your request to switch to Original Medicare. If you also choose to enroll in a Medicare prescription drug plan, your membership in the drug plan will begin the first day of the month after the drug plan gets your enrollment request. 

 

Special Enrollment Period

In certain situations, you may be eligible to end your membership at other times of the year. This is known as a Special Enrollment Period.

  • Who is eligible for a Special Enrollment Period? If any of the following situations apply to you, you are eligible to end your membership during a Special Enrollment Period. These are just examples, for the full list you can contact the plan, call Medicare, or visit the Medicare website.
  • Usually, when you have moved.
  • If you have Medicaid.
  • If you are eligible for Extra Help with paying for your Medicare prescriptions.
  • If we violate our contract with you.
  • If you are getting care in an institution, such as a nursing home or long-term care hospital.

  • When are Special Enrollment Periods? The enrollment periods vary depending on your situation.
  • What can you do? To find out if you are eligible for a Special Enrollment Period, please call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users call 1-877-486-2048. If you are eligible to end your membership because of a special situation, you can choose to change both your Medicare health coverage and prescription drug coverage. This means you can choose any of the following types of plans:

  • Another Medicare health plan. (You can choose a plan that covers prescription drugs or one that does not cover prescription drugs.)
  • Original Medicare with a separate Medicare prescription drug plan.
  • – or – Original Medicare without a separate Medicare prescription drug plan.
    - If you receive Extra Help from Medicare to pay for your prescription drugs: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you have opted out of automatic enrollment.

Note: If you disenroll from Medicare prescription drug coverage and go without creditable prescription drug coverage, you may need to pay a late enrollment penalty if you join a Medicare drug plan later. (“Creditable” coverage means the coverage is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.)

  • When will your membership end? Your membership will usually end on the first day of the month after we receive your request to change your plan.

Usually, to end your membership in our plan, you simply enroll in another Medicare plan during one of the enrollment periods. However, if you want to switch from our plan to Original Medicare without a Medicare prescription drug plan, you must ask to be disenrolled from our plan. There are two ways you can ask to be disenrolled:

  • You can make a request in writing to us. Contact Member Services if you need more information on how to do this.
  • – or – You can contact Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.