Disenrollment rights + responsibilities
We’ll never disenroll (remove) you or ask you to leave our plan because of your health. However, certain situations may cause involuntary disenrollment.
Disenrollment may occur if:
- You don't stay continuously enrolled in Medicare Part A or B (or both).
- You move out of the service area or are away from the plan’s service area for more than six months. (Note: If you plan to move or take a long trip, we encourage you to call Member Services and ask if the place you're moving or traveling to is in our service area.
- You knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drug coverage.
- You continuously behave in a way that is disruptive and makes it hard for us to provide care for you and other plan members. (We can't remove you from our plan for this reason unless we get permission from Medicare first.)
- You don't pay your plan’s monthly premiums. You may be notified in writing that you have a grace period during which you can pay the plan premiums before your membership ends.
- Medicare terminates its contract with Medica Central Health Plan.
- Medica Central Health Plan terminates its contract with Medicare.
- You're found to be unlawfully present in the United States.
If you're involuntarily disenrolled from your Medica Advantage plan, you have the right to ask us to reconsider by filing a grievance. If you have any questions about leaving our plan:
Call our Customer Care Center toll-free at 1-877-301-3326 (TTY: 711)
- Monday - Thursday: 7:30 a.m. - 5 p.m.
- Friday: 8 a.m. - 4:30 p.m.
Potential for contract termination
Coverage or service area availability beyond the end of the current contract year is not guaranteed. Termination or non-renewal of the contract by Centers for Medicare & Medicaid Services (CMS) or Medica Advantage — as authorized by law may end your enrollment in the plan. If this occurs, you can choose another plan without a late enrollment penalty, as long as you do it within the time period required.