Types of Disenrollment. Member Requested Disenrollment All members shall have the right to disenroll from the MCO without cause at any time. If a member expresses a desire to disenroll from the MCO, the MCO shall provide the member with contact information for the resource center; and, with the member’s approval, may make a referral to the resource center for options counseling. If the member chooses to disenroll, the member will indicate a preferred date for disenrollment. The date of voluntary disenrollment cannot be earlier than the date the individual last received services authorized by the MCO. The resource center will notify the MCO that the member is no longer requesting services and the member’s preferred date for disenrollment as soon as possible but this notification will be no later than one (1) business day following the member’s decision to disenroll. The resource center will process the disenrollment. The MCO is responsible for covered services it has authorized through the date of disenrollment. Disenrollment Due to Loss of Eligibility The member will be disenrolled if he/she loses eligibility. The MCO is required to notify the income maintenance agency when it becomes aware of a change in a member’s situation or condition that might result in loss of eligibility. Members lose eligibility when the member: Fails to meet functional eligibility requirements; Fails to meet financial eligibility requirements; Fails to pay, or to make satisfactory arrangements to pay, any cost share amount due the MCO after a thirty (30) calendar day grace period;
Types of Disenrollment. Member Requested Disenrollment All members shall have the right to disenroll from the MCO without cause at any time. If a member expresses a desire to disenroll from the MCO, the MCO shall provide the member with contact information for the resource center; and, with the member’s approval, may make a referral to the resource center for options counseling. If the member chooses to disenroll, the member will indicate a preferred date for disenrollment. The date of voluntary disenrollment cannot be earlier than the date the individual last received services authorized by the MCO. The resource center will notify the MCO that the member is no longer requesting services and the member’s preferred date for disenrollment as soon as possible but this notification will be no later than one (1) business day following the member’s decision to disenroll. The resource center will process the disenrollment. The MCO is responsible for covered services it has authorized through the date of disenrollment.
Types of Disenrollment. Participant-Requested/Voluntary Disenrollment All participants have the right to disenroll from the ICA, FEA, and the IRIS program without cause at any time. If a participant expresses a desire to disenroll from IRIS, the ICA shall provide the participant with contact information for their local ADRC; and with the participant’s approval, may make a referral to the ADRC for options counseling. If the participant chooses to disenroll, the participant will indicate a preferred date for disenrollment. The date of voluntary disenrollment cannot be earlier than the date the individual last received services authorized by the ICA. The ADRC will notify the ICA that the participant is no longer requesting services and the participant’s preferred date for disenrollment as soon as possible, but this notification will be no later than one (1) business day following the participant’s decision to disenroll. The ADRC will process the disenrollment. …
Types of Disenrollment a. Member Requested Disenrollment All members shall have the right to disenroll from the MCO without cause at any time. If a member expresses a desire to disenroll from the MCO, the Indian Health Care Provider (IHCP) shall immediately refer the member to the ADRC or TADRS.
Types of Disenrollment
