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Disenrollment Rights and Responsibilities

Under certain circumstances, you may end your membership with Health First Health Plans. It can be voluntary (your decision) or involuntary (not your decision).

Voluntarily ending your membership

There are only certain times during the year when you may voluntarily end your membership with Health First Health Plans.

In an effort to ensure you are enrolled in plans that best suit your needs and budget, CMS will allow you to make a one-time change into another Medicare Advantage (MA) plan or Original Medicare between January 1 and March 31. If you elect for this option, you may also make a coordinating change to add or drop Part D coverage.

Involuntarily ending your membership

Health First Health Plans will end your membership in our plan if you:

  • Do not stay continuously enrolled in Medicare A or B (or both).
  • Move or live out of the service area for more than 6 months of the year.
  • Become incarcerated.
  • Lose lawful presence status in the United States.
  • Knowingly lie or withhold information about other insurance you have.
  • Intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan.
  • Continuously display disruptive behavior in a way that makes it difficult for us to provide medical care for you or others who are members of our plan (with approval from the Centers for Medicare & Medicaid Services).
  • Let someone else use your plan membership card to get medical care. If we end your membership for this reason, CMS may have your case investigated by the Inspector General.
  • Do not pay the plan premiums. We will tell you in writing that you have a three calendar month grace period during which you may pay the plan premiums before your membership ends.

You have the right to file a complaint if we end your membership in our plan.

If we end your membership in our plan we will tell you our reasons in writing and explain how you may file a complaint against us if you want to. For more information about voluntary or involuntary disenrollment, contact our Care Team or refer to your Evidence of Coverage.

Health First Health Plans is an HMO plan with a Medicare Contract. Enrollment in Health First Health Plans depends on contract renewal.

Y0089_EL9653_M | Accepted date: 10/01/2021
Last updated: 10/01/2021