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.

Medicare allows you to make changes during the Medicare Advantage Annual Enrollment period (October 15th to December 7th). You can also end your membership in our Medicare Advantage Plan during the Medicare Advantage Annual Disenrollment period (January 1st to February 14th), and return to Original Medicare at which time you would also be allowed to join a stand-alone Prescription Drug Plan (PDP). For more information on when you can make changes, you may contact Health First Health Plans.

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 Customer Service or refer to your Evidence of Coverage.

Y0089_MP6562 APPROVED 10/5/2017