Disenrollment (en Español)

What is Disenrollment?

"Disenrollment" means ending your membership in a Cigna Medicare Rx plan. Disenrollment can be voluntary (your own choice) or involuntary (not your own choice).

Some examples:

  • Once you are enrolled in our plan, you can only disenroll (or enroll in a new plan) during certain times of the year. Unless you meet certain special exceptions, such as if you move out of Cigna Medicare Rx service area or if you qualify for Extra Help, you can only disenroll from Cigna Medicare Rx from October 15th through December 7th.
  • There are also a few situations where you would be required to leave, including if you move out of a Cigna Medicare Rx geographic service area, or if Cigna leaves the Medicare program.
  • We are not allowed to ask you to leave the plan because of your health.

Whether leaving the plan is your choice or not, this section explains your Medicare prescription drug coverage choices after you leave and the rules that apply. Until your membership officially ends, you must retain your Medicare prescription drug services through your Cigna plan, or you will have to pay for them yourself.

If you have any questions about how or when to disenroll from your Cigna Medicare Rx plan or changing Cigna plans, please call our Customer Service Department for details.

Voluntary Disenrollment

You may disenroll from Cigna Medicare Rx only during a Special Enrollment Period (SEP) or during the Annual Coordinated Election Period (AEP), which occurs from October 15th through December 7th.

SEPs include those situations where:

  • You have made a change in residence outside the service area or have experienced another change in circumstances as determined by the Centers for Medicare & Medicaid Services (CMS) that causes you to no longer be enrolled in Cigna Medicare Rx.
  • You are entitled to Medicare Part A and Part B and you receive any type of assistance from Medicaid.
  • CMS or the organization has terminated Cigna Medicare Rx's contract for Cigna Medicare Rx in the area in which you reside, or the organization has notified you of the impending termination of or the impending discontinuation of Cigna Medicare Rx in the area in which you reside.
  • You demonstrate that Cigna Medicare Rx substantially violated a material provision of its contract with CMS in relation to you, or Cigna Medicare Rx (or its agent) materially misrepresented Cigna Medicare Rx when marketing Cigna Medicare Rx.
  • You involuntarily lose creditable coverage, including a reduction in the level of coverage so that it is no longer creditable, not including any such loss or reduction due to your failure to pay premiums.
  • You were not adequately informed of the creditable status of drug coverage provided by an entity required to give such notice, or a loss of creditable coverage.
  • Your enrollment or non-enrollment in Cigna Medicare Rx is erroneous due to an action, inaction or error by a Federal Employee.
  • You meet such other exceptional conditions as CMS may provide.

 

During an SEP, you may discontinue enrollment in a Prescription Drug Plan (PDP) offered by a PDP sponsor or change to a different Part D plan. If you disenroll from (or are disenrolled from) Cigna Medicare Rx, you may subsequently enroll in a new Part D plan within the SEP time period. Once you have enrolled in a new Part D plan, the SEP ends for you even if the time frame for the SEP is still in effect.

You may disenroll by:

  • Mailing or faxing a signed written notice to Cigna Medicare Rx, or through Cigna Medicare Rx's employer group/union, where applicable
  • Calling 1.800.MEDICARE 24 hours a day/7 days a week. TTY/TDD users call 1.877.486.2048 24 hours a day/7 days a week.
What are your choices for continuing Medicare Prescription Drug Coverage if you leave a Cigna Medicare Rx plan?

If you leave a Cigna Medicare Rx plan you may have the choice of joining another Medicare Prescription Drug Plan or in a Medicare Health Plan (such as a Medicare HMO or PPO) with prescription drug coverage if any of these types of plans are available in your area and they are accepting new members. Cigna offers many plan options depending upon your need. You may review your options by using our ZIP code searchwhich will show you the plans available in your area.

Please Note: You may not enroll in a new plan during other times of the year unless you meet certain special exceptions, such as if you move out of Cigna Medicare Rx (PDP)’s service area, want to join a plan in your area with a 5-star rating, or you qualify for extra help with your prescription drug costs.

When can you change your Medicare Prescription Drug choices?

Medicare limits when you can make changes to your coverage. You may only disenroll from a Medicare Prescription Drug Plan during a valid enrollment period as outlined below:

  • The Initial Enrollment Period for Part D - The initial enrollment period (IEP) is the period during which an individual is first eligible to enroll in a Part D plan. During this period, individuals may only enroll in a prescription drug plan.
  • The Annual Enrollment Period - The Annual Enrollment Period occurs from October 15th through December 7th. During this period, individuals may enroll, disenroll or choose another prescription drug plan.
  • All Special Enrollment Periods - Individuals must meet special exceptions such as if you move out of the Cigna Medicare Rx service area or if you qualify for Extra Help with your prescription drug costs.

Please call our Customer Service department (See Contact Us for details) to see if you qualify for a Special Enrollment Period.

Each individual has one election per enrollment period; once an enrollment or disenrollment becomes effective, the election has been used. After you request a switch, your plan will let you know, in writing, the date your coverage ends. If you don't get a letter, call the plan and ask for the date.

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. For example, if we receive your request to leave during the month of February, your disenrollment date will be March 1st. There is an exception: if we receive your request between October 15th and December 7th, the change will take effect on January 1 of the following year, unless you specifically ask for a disenrollment date of November 1st or December 1st.

What should you do if you decide to leave a Cigna Medicare Rx plan?

If you want to voluntarily leave a Cigna Medicare Rx, you must take one of the 3 steps outlined below:

  1. Enroll in another prescription drug plan (during a valid enrollment period);
  2. Giving or faxing a signed written notice to us (See Contact Us for details), or through their employer/union group, where applicable;
  3. Call the national Medicare help line at 1-800-MEDICARE (1-800-633-4227), (TTY/TDD users should call 1-877-486-2048).

Your disenrollment request must be signed and dated in order for us to process your disenrollment request.

We will then send you a letter that tells you when your membership will end. This is your disenrollment date, which is the day you officially leave Cigna Medicare Rx.

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 Cigna Medicare Rx and must continue to get your prescription drugs through Cigna Medicare Rx. You should continue to use Cigna Medicare Rx network pharmacies to get your prescription drugs filled until your membership in our plan ends. Usually your prescription drugs are only covered if they are filled at a network pharmacy.

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 happens to you if Cigna leaves the Medicare program or Cigna Medicare Rx leaves the area where you live?

All Medicare Prescription Drug Plans agree to stay in the program for a full year at a time. Each year, the plan decides whether to continue for another year.

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 a description of alternatives for obtaining 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 Cigna Medicare Rx and must continue to get your prescription drugs through Cigna Medicare Rx. You should continue to use Cigna Medicare Rx network pharmacies to get your prescription drugs filled until your membership in our plan ends. Usually your prescription drugs are only covered if they are filled at a network pharmacy.

Cigna HealthCare of Arizona and Connecticut General Life Insurance Company (CGLIC) have contracts with the Centers for Medicare & Medicaid Services (CMS), the government agency that administers the Medicare Program. These contracts renew each year. At the end of each year, the contract is reviewed, and Cigna HealthCare of Arizona, CGLIC, or CMS can decide to end it. You will get 90 days advance notice in this situation. 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 in advance. 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.

Cigna HealthCare of Arizona has contracted with CMS since 1986 and CGLIC has contracted with CMS since 2006.

Under certain conditions Cigna can end your membership and make you leave the plan

We cannot ask you to leave the plan because of your health. No member of any Medicare Prescription Drug Plan can be asked to leave the plan for any health-related reasons. If you ever feel that you are being encouraged or asked to leave a Cigna Medicare Rx 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 the following situations occur, we must end your membership in a Cigna Medicare Rx plan.

  • If you move out of our geographic service area or live outside the plan's service area for more than twelve months at a time.
    • 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 service area.
  • If you do not stay continuously enrolled in Medicare Part A or Medicare Part B (or both).
  • 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 for our plan.
  • If you obtain prescription drugs through altered or falsified prescriptions. Altered or falsified prescriptions are considered a felony in the State of Arizona and other states. Submission of altered or falsified prescriptions to Cigna will result in Cigna HealthCare contacting local law enforcement. Cigna HealthCare 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.
  • If you let someone else use your membership card to get prescription drugs.
    • If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.
  • If you fail to pay your monthly Cigna Medicare Rx plan premium. We will notify you in writing prior to ending your Cigna Medicare Rx coverage.
  • If you die.
You have the right to make a complaint if we ask you to leave a Cigna Medicare Rx Plan.

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 EOC (Evidence of Coverage) for more information about this process and your options.”

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