Disenrollment Rights

It is important that you know that, as a member of our plan, you have rights and responsibilities upon the option of leaving the plan. You may end your membership in our plan only during certain times of the year, known as Enrollment Periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the Medicare Advantage Open Enrollment Period. In certain situations, you may also be eligible to leave the plan at other times during the year. Your disenrollment can be voluntary (your own choice) or involuntary (not your own choice).

Voluntary Disenrollment

If you want to leave our plan, you must do it in writing.  Please include the reason for which you are requesting the disenrollment.  You can send your request by mail, fax, or deliver it to our offices at:

MMM of Florida
P.O. Box 260430
Miami, FL  33126

You can also contact Medicare by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Important: The letter must be signed by the member. In case the member has a legal tutor, it must be indicated in the letter that he/she is the member’s legal tutor and attach the power of attorney.

Involuntary Disenrollment

Our plan must end your membership in any of the following situations:

  • If you lose your entitlement to Medicare Part A and Part B.
  • If you move permanently out of the plan’s service area for six months or more.
  • If you become incarcerated (go to prison).
  • If while enrolled in a dual plan (Medicaid), you lose eligibility to Medicaid and you don’t recertify it under a period of six months (6).
  • If you are enrolled in a plan for Chronic Conditions and the condition(s) is not certified.
  • 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 in our plan.*
  • 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.*
    • If we end your membership because of this reason, Medicare may request for your case to be investigated by the General Inspector.
  • If, because of your income, you are required to pay an extra amount of Part D and you do not pay, Medicare will disenroll you from our plan and you will lose your prescription drug coverage.

*We cannot make you leave our plan for this reason unless we get permission from Medicare first.

 

Voluntary Cancellation

The member can request a cancellation from the plan by:

  • Calling Member Services or sending a letter by fax or mail.
  • Visiting our office
  • Through Medicare by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Important: The letter must be signed by the member. In case the member has a legal tutor, it must be indicated in the letter that he/she is the member’s legal tutor and attach the power of attorney.

 

Information about Medigap Rights

If you decide to switch to Original Medicare, you might have a special temporary right to buy a Medigap policy, also known as Medicare supplement insurance, even if you have health problems. For example, if you are age 65 or older and you enrolled in Medicare Part B within the past 6 months or if you move out of the service area, you may have this special right. Federal law requires the protections described above. Florida may have laws that provide more Medigap protections. If you have questions about Medigap or any special temporary rights you may have, you should contact the Florida State Health Insurance Assistance Program (SHIP), also called Florida Shine at 1-800-96 ELDER (1-800-963-5337); TTY: 1-800-955-8770. You can also call 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Member Rights and Responsibilities

  • If you feel that you are being asked to leave our plan because of a health-related reason, you have the right to file a complaint with Medicare.
  • If we end your membership in our plan and you do not agree with our decision, you have the right to file a complaint with us.
  • If you disenroll, remember the following during the disenrollment process:
    • Until your membership ends, you must continue getting your medical services and/or drugs through our plan. That means you can’t disenroll on a Monday and expect to be on a new plan on Tuesday. You must continue to get your medical care and/or prescription drugs through our plan until the end of the month, when the disenrollment is effective.
    • If your plan includes prescription drug coverage, you should continue to use our network pharmacies to get your prescription drugs filled until your membership in our plan ends.
    • If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins).

For more information on the disenrollment process, please refer to your plan’s Evidence of Coverage (under “Ending your membership in the plan”), call Member Services, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Disenrollment Rights

It is important that you know that, as a member of our plan, you have rights and responsibilities upon the option of leaving the plan. You may end your membership in our plan only during certain times of the year, known as Enrollment Periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the Medicare Advantage Open Enrollment Period. In certain situations, you may also be eligible to leave the plan at other times during the year. Your disenrollment can be voluntary (your own choice) or involuntary (not your own choice).

Voluntary Disenrollment

If you want to leave our plan, you must do it in writing.  Please include the reason for which you are requesting the disenrollment.  You can send your request by mail, fax, or deliver it to our offices at:

MMM of Florida
P.O. Box 260430
Miami, FL  33126

You can also contact Medicare by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Important: The letter must be signed by the member. In case the member has a legal tutor, it must be indicated in the letter that he/she is the member’s legal tutor and attach the power of attorney.

Involuntary Disenrollment

Our plan must end your membership in any of the following situations:

  • If you lose your entitlement to Medicare Part A and Part B.
  • If you move permanently out of the plan’s service area for six months or more.
  • If you become incarcerated (go to prison).
  • If while enrolled in a dual plan (Medicaid), you lose eligibility to Medicaid and you don’t recertify it under a period of six months (6).
  • If you are enrolled in a plan for Chronic Conditions and the condition(s) is not certified.
  • 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 in our plan.*
  • 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.*
    • If we end your membership because of this reason, Medicare may request for your case to be investigated by the General Inspector.
  • If, because of your income, you are required to pay an extra amount of Part D and you do not pay, Medicare will disenroll you from our plan and you will lose your prescription drug coverage.

*We cannot make you leave our plan for this reason unless we get permission from Medicare first.

 

Voluntary Cancellation

The member can request a cancellation from the plan by:

  • Calling Member Services or sending a letter by fax or mail.
  • Visiting our office
  • Through Medicare by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Important: The letter must be signed by the member. In case the member has a legal tutor, it must be indicated in the letter that he/she is the member’s legal tutor and attach the power of attorney.

 

Information about Medigap Rights

If you decide to switch to Original Medicare, you might have a special temporary right to buy a Medigap policy, also known as Medicare supplement insurance, even if you have health problems. For example, if you are age 65 or older and you enrolled in Medicare Part B within the past 6 months or if you move out of the service area, you may have this special right. Federal law requires the protections described above. Florida may have laws that provide more Medigap protections. If you have questions about Medigap or any special temporary rights you may have, you should contact the Florida State Health Insurance Assistance Program (SHIP), also called Florida Shine at 1-800-96 ELDER (1-800-963-5337); TTY: 1-800-955-8770. You can also call 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

Member Rights and Responsibilities

  • If you feel that you are being asked to leave our plan because of a health-related reason, you have the right to file a complaint with Medicare.
  • If we end your membership in our plan and you do not agree with our decision, you have the right to file a complaint with us.
  • If you disenroll, remember the following during the disenrollment process:
    • Until your membership ends, you must continue getting your medical services and/or drugs through our plan. That means you can’t disenroll on a Monday and expect to be on a new plan on Tuesday. You must continue to get your medical care and/or prescription drugs through our plan until the end of the month, when the disenrollment is effective.
    • If your plan includes prescription drug coverage, you should continue to use our network pharmacies to get your prescription drugs filled until your membership in our plan ends.
    • If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins).

For more information on the disenrollment process, please refer to your plan’s Evidence of Coverage (under “Ending your membership in the plan”), call Member Services, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048.

MMM of Florida, Inc. is an HMO plan with a Medicare contract. Enrollment in MMM of Florida depends on contract renewal. This information is not a complete description of benefits. Call 1-844-212-9858 (TTY: 1-833-523-2620) for more information. Every year, Medicare evaluates plans based on a 5-star rating system.  MMM of Florida, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MMM of Florida, Inc. cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-844-212-9858 (TTY:1-833-523-2620). MMM of Florida, Inc. konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-844-212-9858 (TTY:1-833-523-2620).

 

Updated: October 2018

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