• Seeing a Doctor Out-of-Network
• Fill a Prescription Out-of-Network
• Enrollment
  • Eligibility
  • Disenrollment

Disenrollment

VOLUNTARILY ENDING YOUR MEMBERSHIP

There are only certain times during the year when you may voluntarily end your membership in FHCP. The key time to make changes is the Medicare fall open enrollment period (also known as the “Annual Election Period”), which occurs every year from October 15 through December 7. This is the time to review your health care and drug coverage for the following year and make changes to your Medicare health or prescription drug coverage. Any changes you make during this time will be effective January 1. 

If you want to end your membership in our plan during this time, this is what you need to do:

• If you are planning on enrolling in a new Medicare Advantage plan:  Simply join the new plan. You will be disenrolled from our plan when your new plan’s coverage begins on January 1.
• If you are planning on switching to the Original Medicare Plan and joining a Medicare Prescription drug plan:  Simply join the new Medicare Prescription drug plan. You will be disenrolled automatically from our plan when your new coverage begins on January 1.
• If you are planning on switching to the Original Medicare Plan without a Medicare Prescription drug plan:  Contact Member Services for information on how to request disenrollment. You may also call 1-800-MEDICARE (1-800-633-4227) to request disenrollment from our plan. TTY users should call 1-877-486-2048. Your enrollment in Original Medicare will be effective January 1.

INVOLUNTARILY ENDING YOUR MEMBERSHIP

If any of the following situations occur, we will end your membership in FHCP.

• If you do not stay continuously enrolled in Medicare A and B.
• If you move out of the service area or are away from the service area for more than 6 months you cannot remain a member of FHCP.
• If you knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drug coverage.
• If you intentionally give us incorrect information on your enrollment request that would affect your eligibility to enroll in FHCP.
• If you behave in a way that is disruptive, to the extent that your continued enrollment seriously impairs our ability to arrange or provide medical care for you or for others who are members of our Plan. We cannot make you leave FHCP for this reason unless we get permission first from Medicare.
• If you let someone else use your plan membership card to get medical care. If you are disenrolled for this reason, CMS may refer your case to the Inspector General for additional investigation.
• Failure to pay your plan premium.
• Failure to pay your Part D-Income Related Monthly Adjustment Amount (Part D-IRMAA)