Medicare Disenrollment

Voluntary Medicare Disenrollment

You can disenroll from HealthSpring Medicare during the Annual Enrollment Period from October 15 - December 7 or during a Special Enrollment Period. If you are in a Medicare Advantage plan, you may also disenroll during the Open Enrollment Period from January 1 - March 31.

Examples of a SEP include:

• You have moved outside the HealthSpring service area

• You are eligible for Medicare Part A and Part B and you get support from Medicaid

• You can get Extra Help with your Medicare prescription drug costs

• You start care in a nursing home or long-term care facility

• You join the Program of All-inclusive Care for Elderly (PACE)

• You meet other special conditions from the Centers for Medicare & Medicaid Services

Cancelling Your HealthSpring Medicare plan

You may disenroll one of two ways:

• Enrolling in another prescription drug plan during a valid enrollment period

• Mail or fax a signed written disenrollment request to:

For Medicare Advantage Plans
HealthSpring Medicare E&E Team
P.O. Box 239
Nashville, TN 37202

Fax: 1-866-785-7444

For Medicare Prescription Drug Plans
HealthSpring Medicare Prescription Drug Plans
P.O. Box 269005
Weston, FL 33326-9927

Fax: 1-800-735-1469

Note: Your disenrollment ask must be signed and dated for it to be reviewed.

• You should contact your employer group/union sponsor of HealthSpring, where applicable

• Calling 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY/TDD users call 1-877-486-2048 24 hours a day, 7 days a week.

Medicare Disenrollment Timing

We will send you a letter that tells you when your membership will end. This is your disenrollment date, which is the day you officially leave HealthSpring. It may take time before your membership ends and your new Medicare coverage goes into effect. While you are waiting for your membership to end, you are still a member of your HealthSpring plan. You should keep using your benefits until your membership ends.

If you want to talk to someone who can help you decide if this is right for you, call your State Health Insurance Assistance Program.

What if HealthSpring leaves the Medicare program or the area where I live?

If we leave the Medicare program or change our service area so that it no longer includes the area where you live, we will give you written notice of the effective date of termination and include different ways to get benefits under the Medicare program.

All of the benefits and rules described in the Evidence of Coverage will continue until your membership ends. While you are waiting for your membership to end, you are still a member of the HealthSpring plan and must keep getting your prescription drugs through HealthSpring. You should keep using the HealthSpring network pharmacies to get your prescription drugs filled until your membership in our plan ends. Often your prescription drugs are only covered if they are filled at a network pharmacy.

HealthSpring has contracts with the Centers for Medicare & Medicaid Services, the government agency that runs the Medicare Program. These contracts renew each year. At the end of each year, the contract is reviewed and HealthSpring or CMS can decide to end it. You will get 90 days advance notice if this happens. It is also possible for our contract to end at some other time too. If the contract is going to end, we will generally tell you 90 days ahead of time. Your advance notice may be as little as 30 days, or even fewer days, if CMS must end our contract in the middle of the year.

Involuntary Medicare Disenrollment

We cannot and will not ask you to leave the plan because of your health. No member of any Medicare Advantage or Part D Prescription Drug plan can be asked to leave the plan for any health-related reasons. If you ever feel that you are being asked to leave a HealthSpring plan because of your health, you should call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You may call 24 hours a day, 7 days a week.

We can ask you to leave the plan under certain special conditions. If any of these situations happen, we must end your membership in a HealthSpring plan:

• You are enrolled in a PDP plan and you move out of our geographic area or live outside the plan’s service area for more than 12 months at a time.

• You are enrolled in a Medicare Advantage plan and you are away from our service area for more than 6 months.

  • If you move or take a long trip, you need to call Customer Service to find out if the place you are moving or traveling to is in our plan’s area.

• You do not pay your premiums.

• You move out of our service area.

• You are incarcerated (go to prison).

• You do not stay continuously enrolled in Medicare Part A or Medicare Part B (or both).

• You lie about or withhold information about other insurance you have that provides prescription drug coverage.

• You intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan.

• You get prescription drugs through changed or falsified prescriptions.

  • Altered or falsified prescriptions are considered a felony in many states. Submission of altered or falsified prescriptions to HealthSpring will result in HealthSpring contacting local law enforcement. HealthSpring will prosecute to the fullest extent of the law and submit an Involuntary Disenrollment request to CMS.

  • If you have a question or concern regarding a prescribed medication, please address your concerns with the prescribing provider.

• You let someone else use your membership card to get prescription drugs or medical care.

  • If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.

• You are required to pay the extra Part D amount because of your income and do not pay it. Medicare will disenroll you from our plan and you will lose prescription drug coverage.

Complaints

If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership.

Please reference your Evidence of Coverage for more information about this process and your options.