MEDICARE ADVANTAGE MEMBER DISENROLLMENT RIGHTS AND RESPONSIBILITIES
How to end your membership in our plan:
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.
If you would like to switch from our plan to:
This is what you should do:
We must end your membership if the following occur:
- If you no longer have Medicare Part A and Part B.
- If you are enrolled in a Special Needs plan (C-SNP or D-SNP) and you lose your special needs status.
- If you move out of our service area.
- If you are away from our service area for more than six months.
- If you move or take a long trip, you need to call Customer Care to find out if the place you are moving or traveling to is in our plan’s area.
- If you become incarcerated (go to prison).
- If you become deceased.
- If you are not a United States citizen or lawfully present in the United States.
- If you lie about or withhold information about other insurance you have that provides prescription drug coverage.
- If you intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.)
- If you continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.)
- If you let someone else use your member ID card to get medical care. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.)
- If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.
- If you are required to pay the extra Part D amount because of your income and you do not pay it, Medicare will disenroll you from our plan and you will lose prescription drug coverage.
We cannot ask you to leave our plan for any reason related to your health.
We must tell you our reasons in writing for ending your membership.
If you think you have been wrongly disenrolled:
If you feel that you are being asked to leave our plan because of a health-related reason, you should call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY:711) users should call 1-877-486-2048. You may call 24 hours a day, 7 days a week.
You can file a grievance or make a complaint about our decision to end your membership. You can contact us either by phone or in writing.
Click here for more information about Appeals and Grievances.
How to contact us:
Our Customer Care number is 1-844-280-5555 (toll-free). (TTY users should call 711.) Hours are 8:00 am to 8:00 pm, seven days a week, from October 1 – March 31, and 8:00 am to 8:00 pm Monday – Friday from April 1 – September 30.
Global Health, Inc.
Attn: Eligibility Department
P.O. Box 1678
Oklahoma City, OK 73101