Medicare Disenrollment Rights and Responsibilities

You may end your membership in our plan only during certain times of the year, known as election periods.

Annual Enrollment Period (AEP)

• From October 15 – December 7 each year, you can join, switch, or drop a plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7).

Medicare Advantage Open Enrollment Period (MA-OEP) 

• From January 1 – March 31 each year, if you are enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time. Your membership will end on the first day of the month after we get your request to switch to another plan. Note: You can only switch plans once during this period.

Special Enrollment Period (SEP)

• In special situations, you may be eligible to end your membership outside of the AEP or OEP. To find out if you are eligible for an SEP, please call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users call 1-877-486-2048.

• If you are eligible to end your enrollment because of a special situation and you choose to leave Elevate Medicare Advantage, your membership will end on the first day of the month after we get your request to switch to another plan. 
• If any of the following situations apply to you, you are eligible to end your membership during an SEP. The enrollment period may vary depending on your situation. These are just examples. For the full list, please contact Health Plan Services at 303-602-2111 or toll-free 1-877-956-2111. TTY users call 711. You may also contact Medicare (1-800-633-4227) or visit Medicare.gov.
  • You have moved outside of our service area
  • You have Medicaid
  • You are eligible for Extra Help with paying for your Medicare prescriptions
  • If we violate our contract with you
  • If you are getting care in an institution, such as a nursing home or long-term care hospital.
  • The enrollment period may vary depending on your situation.

Usually, to end your membership in our plan, you enroll into 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 may ask to be disenrolled from our plan. There are two ways you can ask to be disenrolled:

1. You can make a request in writing to us. Contact Health Plan Services at 303-602-2111 or toll-free 1-877-956-2111. TTY users call 711.
2. You can contact Medicare at 1-800-MEDICARE 1-800-633-4227, 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.

If you disenroll from Medicare prescription drug coverage and go without credible coverage, you may need to pay a late enrollment penalty if you join a Medicare drug plan later. “Credible” coverage means the coverage is expected to pay, on average, as much of Medicare’s standard prescription drug coverage.

• You must continue to use network pharmacies (if you have prescription drug coverage) until you are disenrolled from our plan.
• You may only disenroll or switch Medicare Advantage plans or prescription drug plans under certain circumstances.
• You have the right to make a complaint if we ask you to leave our plan.

We will let you know, in writing, the date your coverage ends. We have the right to disenroll you for the following reasons:

• Loss of Medicare Parts A and/or B
• You permanently moved from our service area for more than six consecutive months
• We are no longer contracting with Medicare or we leave your service area
• You fail to pay your plan premium
• You provide fraudulent information when you enroll or let someone else use your membership card to get services
• Disruptive behavior
• Elevate Medicare Choice (HMO D-SNP) only: You lose your Medicaid or Qualified Medicare Beneficiary (QMB) eligibility for more than six months.