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).
*In certain situations, you may also be eligible to leave at other times of the year.
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.
Please note: Disenrollment requests will be effective for the first of the following month in which the request is received. Exception: if you are utilizing an AEP election, then the effective date will always be 1/1.
How to end your membership
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 by downloading the form and mailing the disenrollment request form to:
PO Box 55011
Boston, MA 02205
Or, you may fax the disenrollment request form to: (617) 246-8506. Contact Member Service if you need additional assistance. (See number below).
- 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.
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.
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 don't stay continuously enrolled in Medicare Part A and Part B.
- 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).
When your membership ends
Whether the end of your membership is voluntary or involuntary, you will be notified in writing of your disenrollment from the plan.
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.