Voluntary Disenrollment. If you wish to cancel your benefits by disenrolling, you should discuss this with a program representative at your center. You will be asked to sign a Department approved disenrollment form (see Appendix H), which will indicate that you will no longer be entitled to services through LIFE. You may voluntarily disenroll from LIFE without cause at any time. Your disenrollment will be effective the first day of the month following the date your LIFE Provider receives notice of your voluntary disenrollment. You may not disenroll from LIFE at a Social Security office. Your social worker will assist you in returning to the appropriate Medicare and/or Medical Assistance Program. The Medicare or Medical Assistance Program you enroll into upon disenrollment from LIFE may not provide you with the full range of services available to you through LIFE. Your LIFE Provider can terminate your benefits, if: • You move out of the LIFE service area. • You consistently do not comply with your individual care plan and/or terms of this agreement and are competent to make decisions for yourself. • You or your caregiver engage in disruptive or threatening behavior. • You fail to pay, or fail to make satisfactory arrangements to pay, any premium due to LIFE, any applicable Medical Assistance spend down, or any amount due under the post-eligibility treatment of income process after a 30-day grace period. • You are out of the service area for more than 30 consecutive days without prior approval from your LIFE Provider. • You no longer meet the eligibility requirements for the program. • The agreement with the CMS and the Department is terminated. • LIFE loses the contracts and/or licenses enabling it to offer health care services. Before you are involuntarily disenrolled from LIFE, the Department must approve the involuntary disenrollment. You will then be provided with a 30 calendar day written notice by your LIFE Provider. Your disenrollment will be effective the first day of the month following the month in which your 30 calendar day advance notice of disenrollment ends. Until the date enrollment is terminated, you must continue to use the LIFE organization services and remain liable for any premiums, and the LIFE organization must continue to furnish all needed services. Before disenrollment, the LIFE organization will make appropriate referrals and ensure medical records are made available to new providers within 30 calendar days, and work with CMS and the Department to reinstat...
Voluntary Disenrollment. 1. A Participant may disenroll voluntarily from ACAP at any time without cause. To disenroll, the Participant or, if appropriate, the Participant's representative must notify a member of the Contractor's staff. The Contractor must use the Voluntary Disenrollment Letter in Appendix J to notify the Participant and, if appropriate, the Participant's representative of the last day the Participant can receive Authorized Services.
2. The Contractor shall submit a copy of the Voluntary Disenrollment Letter to BSASP within three (3) business days of sending the letter.
3. The Contractor shall inform Participants annually of their right to terminate their enrollment voluntarily at any time and the process for exercising the right to voluntarily terminate enrollment, as well as the alternatives available to the Participants based on the Participant’s specific circumstances.
Voluntary Disenrollment. All legal guardians for members enrolled in FCMH shall have the right to disenroll their child from the PIHP at any time for any reason. The PIHP will promptly forward to the enrollment specialist all requests from the member’s parent/legal guardian for disenrollment. Disenrollment requests will be processed as soon as possible and will be effective the last day of the month. Payment(s) made for the member disenrolled the last day of the month will be recouped based on a daily rate. The PIHP must direct all members with disenrollment requests to the Department’s Enrollment Specialist for assistance and/or for choice counseling.
Voluntary Disenrollment. The contractor shall assure that enrollees who disenroll voluntarily are provided with an opportunity to identify, in writing, their reasons for disenrollment. The contractor shall further:
1. Require the return, or invalidate the use of the contractor's identification card; and
2. Forward a copy of the disenrollment request or refer the beneficiary to DMAHS/HBC by the eighth (8th) day of the month prior to the month in which disenrollment is to become effective.
Voluntary Disenrollment. The STAR+PLUS MMP shall have a mechanism for receiving timely information about all disenrollments from the STAR+PLUS MMP, including the effective date of disenrollment, from CMS and HHSC or its Administrative Services Contractor. All disenrollment-related transactions will be performed by HHSC or the Administrative Services Contractor consistent with the Enrollment effective date requirements set forth in the Medicare-Medicaid Enrollment and Disenrollment Guidance. Subject to 42 C.F.R. §§ 423.100 and 423.153(f), Enrollees can elect to disenroll from the STAR+PLUS MMP or the Demonstration at any time and enroll in another STAR+PLUS MMP, a STAR+PLUS MCO, a Medicare Advantage plan, PACE; or may elect to receive services through Medicare fee-for-service (FFS) and a prescription drug plan and to receive Medicaid services in accordance with the Texas State Plan and any waiver programs (if eligible). CMS will alert HHSC and the STAR+PLUS MMP of individuals identified as at risk or potentially at risk for abuse or overuse of specified prescription drugs that may not be disenrolled. Disenrollments received by HHSC or its Administrative Services Contractor, or by CMS or its contractor, either orally or in writing, by the last calendar day of the month will be effective on the first calendar day of the following month.
2.3.5.1.1. The STAR+PLUS MMP may not request disenrollment on behalf of an Enrollee, except as outlined in Section 40.3 of the Medicare-Medicaid Plan Enrollment and Disenrollment Guidance.
2.3.5.1.2. The STAR+PLUS MMP shall be responsible for ceasing the provision Covered Services to an Enrollee upon the effective date of disenrollment.
Voluntary Disenrollment. You may choose to disenroll from PACE CNY at any time for any reason. If you want to disenroll, please let a PACE CNY staff member know. Your effective date of disenrollment will be coordinated between Medicare and/or Medicaid depending upon your eligibility. You may discuss the timing of your disenrollment with your interdisciplinary team to ensure that your coverage is not interrupted. You cannot be put back on another Medicare and/or Medicaid plan until the first of the month after disenrolling. PACE CNY will be responsible for coordinating your Medicare and /or Medicaid benefits until the end of the month in which you disenroll. During this disenrollment period, PACE CNY will continue to provide your authorized services. You must pay any monthly charge until the disenrollment is complete. If you choose to disenroll, PACE CNY will work with you to make referrals to appropriate medical providers in your community, and we will make medical records available in a timely manner. If applicable, we will work with Medicaid to help you transition to an appropriate Managed Long Term Care Plan. Electing enrollment in any other Medicare or Medicaid prepayment plan or optional benefit, including hospice benefit or Part D plan, after enrolling as a PACE CNY participant is considered voluntary disenrollment from PACE CNY.
Voluntary Disenrollment. 2.3.6.1.1. The Contractor shall have a mechanism for receiving timely information from CMS and RI EOHHS or its vendor about all disenrollments from the Contractor, including the effective date of disenrollment. All disenrollment-related transactions will be performed by RI EOHHS.
2.3.6.1.2. Enrollees may elect to voluntarily disenroll from the Contractor’s MMP or the Demonstration at any time. Enrollees who disenroll will have the choice to enroll in or remain in Rhody Health Options, or any other Medicaid program that may be available to Medicare- Medicaid Beneficiaries for Medicaid services only. For Medicare benefits, individuals who Opt-Out of the Demonstration will have the choice to enroll in a MA-PD plan, or receive FFS Medicare and enroll in a PDP. Medicare-Medicaid Beneficiaries eligible for the Demonstration may also be eligible to enroll in PACE, if they choose not to enroll in the Demonstration. Outreach and Enrollment notices for the Demonstration will inform Medicare-Medicaid Beneficiaries of all Enrollment options.
2.3.6.1.3. Disenrollment requests received by RI EOHHS or its designee, or by CMS or its Contractor, either orally or in writing, by the last calendar day of the month will be effective on the first calendar day of the following month.
2.3.6.1.4. The Contractor may not request disenrollment on behalf of an Enrollee.
2.3.6.1.5. The Contractor shall be responsible for ceasing the provision of Covered Services to an Enrollee upon the effective date of disenrollment.
2.3.6.1.6. The Contractor shall not interfere with the Enrollee’s right to disenroll through threat, intimidation, pressure, or otherwise.
Voluntary Disenrollment. 2.3.6.1.1. The Contractor shall have a mechanism for receiving timely information from CMS and RI EOHHS or its vendor about all disenrollments from the Contractor, including the effective date of disenrollment. All disenrollment-related transactions will be performed by RI EOHHS.
Voluntary Disenrollment. A participant can choose to voluntarily disenroll from PACE services at any time. PACE organization staff notify the APD/AAA case manager of the participant’s decision to disenroll. The PACE organization staff must provide the APD/AAA case manager with documentation stating the reason for the disenrollment as well as any health-related information necessary to ensure continued eligibility and transition service planning.
Voluntary Disenrollment. Participants may only voluntarily disenroll from the CHC program if:
