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  • Ending Membership
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    Ending Your Membership

    There may come a time when you choose to end your Medicare coverage with us, or you become ineligible for coverage. In these instances, your coverage can be ended. Whether the end of your membership is voluntary or involuntary, you will be notified in writing of your disenrollment from the plan.

    How to Disenroll from your Medicare Advantage plan

    You may end your membership in our plan only during certain times of the year, known as enrollment periods.*

    You can cancel your plan during:

    • The Annual Enrollment Period (October 15 to December 7 of each year)
    • The Annual Medicare Advantage Open Enrollment Period (January 1 to March 31 of each year)
    An empty blue calendar
    Three pieces of wood cut to shape the outline of houses

    Reasons for ending your membership

    Ending your membership in our plan may be voluntary or involuntary:

    • You might leave our plan because you want to leave.
    • There are only certain times during the year, or certain situations, when you may voluntarily end your membership. Chapter 10, Section 2 in the Evidence of Coverage tells you when you can end your membership in the plan.
    • The process for voluntarily ending your membership varies depending on what type of new coverage you are choosing. Chapter 10, Section 3 in the Evidence of Coverage tells you how to end your membership in each situation.

    Note: Disenrollment requests will be effective for the first of the following month in which the request is received. Except if you are using an AEP election, then the effective date will always be 1/1.

    How to end your membership

    In most cases, 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.

    To request disenrollment from one of our plans, complete the form below that corresponds to your plan type. You may return the completed disenrollment form by mail to the address listed on the form, or fax the completed form to (617) 246-8506.

    • Disenrollment form for HMO plans
    • Disenrollment form for PPO plans

    If you need assistance, contact Member Services at 1-800-200-4255 (TTY: 711). (April 1 through September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday, and from October 1 through March 31, 8:00 a.m. to 8:00 p.m. ET, seven days a week.)

    To contact Medicare, call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. TTY users call 1-877-486-2048.

    Note: If you discontinue your 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. See Chapter 6, Section 9 of your Evidence of Coverage for more information about the late enrollment penalty.

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    Instances when we end your membership

    There are certain situations where we must end your membership in the plan. A few common examples include:

    • If you move out of our service area.
    • Failure to pay the plan premiums for two calendar months.

    For a complete list of situations where we must end your membership in the plan, see Chapter 10, Section 5 of your Evidence of Coverage.

    If you're leaving our plan, you must continue to get your medical care and prescription drugs through our plan until your membership ends.

    If you leave our plan, it may take time before your membership ends and your new Medicare coverage goes into effect. During this time, you must continue to get your medical care and prescription drugs through our plan.

    • You should continue to use our network pharmacies to get your prescriptions filled until your membership in our plan ends.
    • Usually, your prescription drugs are only covered if they're filled at a network pharmacy or through our mail-order pharmacy services.
    • If you're hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you're discharged (even if you're discharged after your new health coverage begins).

    Questions

    If you have any questions or would like more information on when you can end your membership:

    • Call Member Service at 1-800-200-4255 (TTY: 711), as follows: from April 1 through September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday, and from October 1 through March 31, 8:00 a.m. to 8:00 p.m. ET, seven days a week.
    • You can find the information in the Medicare & You Handbook. Download a copy from the Medicare website. Or, you can order a printed copy by calling Medicare at the number below.
    • Call Medicare directly at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
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    *In certain situations, you may also be eligible to leave at other times of the year

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      お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-472-2689(TTY: 711)。

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      BAA !KOHWIINDZIN DOO&G&: Din4 k’ehj7 y1n7[t’i’go saad bee y1t’i’ 47 t’11j77k’e bee n7k1’a’doowo[go 47 n1’ahoot’i’. D77 bee an7tah7g7 ninaaltsoos bine’d44’ n0omba bik1’7g7ij8’ b44sh bee hod77lnih call 1-800-472-2689 (TTY: 711).

      Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association. ® , ® , TM, SM Registered, Service, and Trade Marks are the property of their respective owners. © 2024 Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.

      Blue Cross Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. The joint enterprise is a Medicare-approved Part D Sponsor. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 

      You can file a complaint if you feel that you received inaccurate, misleading or inappropriate information. Please call Member Service at 1-800-200-4255 (TTY users call: 711). If your complaint involves a broker or agent, be sure to include the name of the broker/agent when filing your complaint.

      Y0014_24100_M_2025 | S2893_2432_2025 | Last Updated: 10/01/2024