Disenrollment from the Passport Advantage (HMO-SNP) may occur voluntarily or involuntarily.
  • Voluntary disenrollment from the plan happens when you, the member, make the decision to leave the plan.
  • Involuntary disenrollment from the plan happens when you, the member, are required to leave the plan for reasons other than your decision.
Voluntary Disenrollment from Passport Advantage (HMO-SNP)
  • Passport Advantage members can disenroll from the plan, but this disenrollment can only occur during certain time periods. These time periods are referred to as election periods.
  • Eligible election periods for disenrollment are:
    • Annual Election Period:
    • Medicare Advantage Disenrollment Period
    • Special Election Period

Annual Election Period

  • It occurs from October 15 to December 7 of the calendar year.
  • A member can choose to keep or make changes to their current plan coverage, including enrolling in another plan.
    • Enrollment in another plan will disenroll you from you current plan.
    • Disenrollment from prescription drug plan coverage can result in possible late enrollment penalties. Ask your Passport Advantage representative about LEP (Late Enrollment Penalty).
  • Changes made during the Annual Election Period will take effect on January 1 of the calendar year.
    • For example, if you enrolled in another plan during the Annual Election Period then your new plan would start on January 1 and your old coverage would end on December 31.

Medicare Advantage Disenrollment Period

  • It occurs from January 1 to February 14 of the calendar year.
  • Plan members can cancel their plan and switch back to Original Medicare.
    • It is important to remember than if you elect to switch back to Original Medicare, then you have until February 14 to choose another Medicare prescription drug plan.
  • Changes made during this period will take effect on the first day of the month after Passport Advantage received your request to go back to Original Medicare.
    • This means your Passport Advantage plan coverage will end of the last day of the month when you get your request.

Special Election Periods

  • This time periods occur when certain requirements are met. These Special Election Periods can happen at any time.
    • For a full list of the Special Election Periods, you can speak with our Member Services department at 1-844-859-6152 (TTY/TDD 711) or CMS at 1-800-MEDICARE.
  • Plan member can do the following during a Special Election Period:
    • Choose another Medicare plan.
    • Change back to Original Medicare.
    • Remember that disenrollment from prescription drug plan coverage can result in possible late enrollment penalties. Ask your Passport Advantage representative about LEP (Late Enrollment Penalty).
  • Changes made during the Special Election Period will take effect on the first day of the month after your change request is received.
  • You can voluntarily disenroll through the following means:
    • Submit a request to us in writing.
    • Enroll in another plan. This will disenroll you from your current plan.
    • Contact CMS at 1-800-MEDICARE.
Involuntary Disenrollment from Passport Advantage (HMO-SNP)
  • You will be involuntarily disenrolled from the plan if you fall into any variety of categories.  Some examples may include:
    • Change of residence
    • Loss of enrollment in Part A and/or Part B
    • Loss of special needs status
    • If you do not stay continuously enrolled in Medicare Part A and Part B
    • If you permanently move out of our service area.
    • If you are away from our service area for more than 6 months.
    • If you become incarcerated.
    • 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.
    • If you let someone else use your membership card to get medical care.
  • For more information for the types of events that can cause involuntary disenrollment, please contact Passport Advantage’s Member Services department at 1-844-859-6152 (TTY/TDD 711); available from February 15 – September 30, Mon – Fri, 8 a.m. to 8 p.m. (EST) and  from October 1 to February 14, 7 days a week, 8 a.m. to 8 p.m. (EST) or Medicare at 1-800-Medicare (1-800-633-4227), 24 hours a day, 7 days a week; TTY users call 1-877-486-2048.
  • Involuntary disenrollments take effect based on the event that caused the involuntary disenrollment
  • If you are involuntarily disenrolled, please contact our Member Services department for more information on your next steps.

 

Last Modified: October 13, 2017