You have rights and responsibilities if you leave Capital Health Plan Advantage Plus, Preferred Advantage, or Retiree Advantage (HMO).
Disenrollment Periods
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 (October 15 - December 7 each year) and during the Annual Disenrollment Period (January 1 - February 14 each year). You may be eligible to leave the plan at other times of the year if you move out of the plan's service area, you have Medicaid, you are eligible for Extra Help, or you live in a facility such as a nursing home.
If you have questions about enrollment periods, please call Capital Health Plan Member Services.
Disenrollment Process
You can write or fax a letter to us, or fill out a disenrollment form and send it to:
Capital Health Plan, Member Services
P.O. Box 15349
Tallahassee, Florida 32317-5349
Fax: (850) 523-7369
Be sure to sign and date your letter or form. To get a disenrollment form, call (800) MEDICARE/(800) 633-4227, 24 hours a day, 7 days a week. TTY Users should call (877) 486-2048.
After you submit your disenrollment form, we will send you a letter that tells you when your membership will end. This is your disenrollment date, the day that you officially leave Capital Health Plan. In most cases, your disenrollment date will be the first day of the month that comes after the month we receive your request to leave. While you are waiting for your membership to end, you are still a member of Capital Health Plan and must continue to get your health care as usual through Capital Health Plan.
Medicare Choices upon Disenrollment
You may be eligible to join another Medicare Advantage plan or other Medicare Health Plan. You also can choose Original Medicare. If you choose Original Medicare, you must choose a Prescription Drug Plan if you wish to continue to have Medicare prescription drug coverage.
If you change to Original Medicare you may consider a Medigap policy to supplement your Original Medicare coverage. For Medigap advice, you should contact SHINE at (800) 963-5337, TTY (800) 955-8771.
You may also have a guaranteed issue right if you move out of our service area or if we stop providing Medicare benefits. SHINE can tell you about other situations in which you may have guaranteed issue rights. You will automatically be enrolled in Original Medicare when you leave Capital Health Plan if you do not enroll in another Medicare plan.
Potential for Contract Termination
Capital Health Plan has a contract with the Centers for Medicare and Medicaid Services (CMS), the government agency that runs Medicare. This contract renews each year. All Medicare Advantage Plans agree to stay in the program for a full calendar year at a time. Plan benefits and cost-sharing may change from calendar year to calendar year. Each year, plans can decide whether to continue to participate with Medicare Advantage. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue for an additional calendar year, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.
Last updated: 8/16/2016