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Disenrollment / en Español
- What is disenrollment?
- What are your choices for continuing Medicare if you leave CIGNA Medicare Select Plus Rx (HMO)?
- When can you change your Medicare choices?
- What should you do if you decide to leave CIGNA Medicare Select Plus Rx?
- How can you change from CIGNA Medicare Select Plus Rx to Original Medicare?
- What happens to you if CIGNA leaves the Medicare program or CIGNA Medicare Select Plus Rx leaves the area where you live?
What is Disenrollment?"Disenrollment" means ending your membership in a CIGNA Medicare Select Plus Rx plan or terminating a supplemental benefit offered by a plan, e.g. dental. Disenrollment can be voluntary (your own choice) or involuntary (not your own choice). Some examples:
- You might leave CIGNA Medicare Select Plus Rx because you have decided that you want to leave. You can do this for any reason, but only if you have disenrollment options available to you.
- There are also a few situations where you would be required to leave, including if you move out of our 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 coverage choices after you leave and the rules that apply.
Until your membership officially ends, you must obtain your Medicare services through CIGNA or you will have to pay for them yourself.
If you leave a CIGNA Medicare plan, it takes some time for your membership to end and your new way of getting Medicare to take effect (we discuss when the change takes effect later in this section). While you are waiting for your membership to end, you are still amember and must continue to get your care as usual through CIGNA. If you get services from doctors or other medical providers who are not plan providers before your membership in CIGNA Medicare Select Plus Rx ends, neither CIGNA nor the Medicare program will pay for these services, with just a few exceptions. The exceptions are:
- Urgently needed care, care for amedical emergency, out-of-area renal (kidney) dialysis services and care that has been approved by us.
- If you happen to be hospitalized on the day your membership ends. If this happens, call Customer Service at the number on your ID card.
If you have any questions about leaving CIGNA or changing CIGNA plans, please call Customer Service.
What are your choices for continuing Medicare if you leave a CIGNA Medicare plan?If you leave a CIGNA Medicare plan, one choice for continuing with Medicare is to go to Original Medicare. You may also have the choice of joining another Medicare Advantage plan, if any of these types of plans are available in your area, you are qualified to enroll and they are accepting new members. CIGNA offers additional plan options depending upon your need. You may review your options by using our ZIP code search which will show you the plans available in your area.
- Original Medicare is available throughout the country. It is a pay-per-visit or "fee-for-service" health plan that lets you go to any doctor, hospital or other health care provider that accepts Medicare. The Original Medicare plan has a deductible. Medicare pays its share of the Medicare-approved amount, and you pay your share. Original Medicare has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).
- Medicare Advantage plans (such as HMOs or PPOs) are available in some parts of the country. In HMOs you go to the doctors, hospitals, and other providers that are part of the plan. In PPOs, you can usually see any doctor but you may pay more to see doctors, hospitals, and other providers that are not part of the plan. These plans must cover all Medicare Part A and Part B health care. Some plans cover extras, like prescription drugs. CIGNA Medicare Select Plus Rx is a Medicare Advantage plan offered by CIGNA HealthCare of Arizona, Inc.
When can you change your Medicare choices?You can only change plans under certain circumstances.
- You can choose to switch your current plan from October 15 through December 7. Your enrollment becomes effective January 1 and is generally for the calendar year.
- In certain cases, such as if you move outside your plan's service area or enter a nursing home, you can switch your plan. 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 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 1. There is an exception: if we receive your request between October 15 and November 30, the change will take effect on January 1 of the following year, unless you specifically ask for a disenrollment date of November 1 or December 1
What should you do if you decide to leave a CIGNA Medicare plan?If you want to leave CIGNA Medicare Select Plus Rx, what you must do to leave depends on whether you want to change to Original Medicare or to one of your other choices.
You can switch your Medicare plan in one of three ways:
- Join another Medicare plan.
- Write or call us (See the Contact Us page for details).
- Call the national Medicare help line: 1-800-MEDICARE (1-800-633-4227), (TTY/TDD users should call 1-877-486-2048), 7 days week, 24 hours a day.
If you want to switch from a Medicare Advantage plan or other Medicare health plan to Original Medicare and buy amedigap policy, you need to contact us or call the number above.
Simply signing up for the Medigap policy won't end your Medicare Advantage plan or other Medicare health plan coverage. Medigap policies that include prescription drug coverage are not being offered after January 1, 2006. In some cases, you may not be able to buy amedigap policy.
If you want to talk to someone who can help you decide if this is right for you, call the Arizona Health Insurance Assistance Program at 1-800-432-4040 (TTY: 602-542-6366)
How can you change from a CIGNA Medicare Select Plus Rx plan to Original Medicare?If you decide to change from CIGNA Medicare Select Plus Rx to Original Medicare, you must tell us in writing that you want to leave CIGNA. You do not have to notify Original Medicare, because you will automatically be enrolled in Original Medicare when you leave CIGNA.
First, use any of the following ways to tell us that you want to leave CIGNA Medicare Select Plus Rx:
- You can write to us or fill out a disenrollment form and send it to the address below. Be sure to sign and date your letter of disenrollment.
CIGNA Medicare Services
Attn: Enrollment & Eligibility
25500 N. Norterra Drive
Phoenix, AZ 85085
- You can fax a letter or disenrollment form to us at 623-277-1053. Be sure to sign and date your letter or disenrollment form and include your CIGNA ID number. To get a disenrollment form, call us at 1-800-973-2580, option 1.
- You can call the national Medicare help line at 1-800-MEDICARE (1-800-633-4227) (TTY/TDD users should call 1-877-486-2048). This number is available 7 days a week, 24 hours a day.
- You can contact your nearest Social Security office or, if you have Railroad Retirement benefits, you can contact the Railroad Retirement Board office.
We will then send you a letter that tells you when your membership will end. This is your disenrollment date, the day you officially leave CIGNA. While you are waiting for your membership to end, you are still amember of CIGNA Medicare Select Plus Rx and must continue to get your medical care as usual through CIGNA.
On your disenrollment date, your membership in CIGNA Medicare Select Plus Rx ends, and you can start using your red, white and blue Medicare card to get services under Original Medicare. You will not get anything in writing that tells you that you have Original Medicare, because you will automatically be enrolled in Original Medicare when you leave CIGNA. To get a new red, white and blue Medicare card, call Social Security at 1-800-772-1213.
For more information about disenrollment, call 1-800-973-2580, option #1
What happens if CIGNA leaves the Medicare program or CIGNA leaves the area where you 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 tell you in writing. If this happens, your membership in CIGNA Medicare Select Plus Rx will end, and you will have to change to another way of getting your Medicare benefits. All of the benefits and rules described in the Evidence of Coverage will continue until your membership ends. This means that you must continue to get your medical care in the usual way through CIGNA until your membership ends.
Your choices will always include Original Medicare. Your choice may also include joining another Medicare managed care plan or a Private Fee-for-Service plan, if these plans are available in your area and are accepting new members. Once we have told you in writing that we are leaving the Medicare program or the area where you live, you may change to another way of getting your Medicare benefits. If you decide to change from CIGNA Medicare Select Plus Rx to Original Medicare, you may have the right to buy amedigap policy regardless of your health. This is called a "guaranteed issue right."
CIGNA HealthCare of Arizona, Inc. is a Medicare Advantage Organization with a Medicare contract that offers various individual plans (including CIGNA Medicare Select Plus Rx - Dual (HMO SNP), a Coordinated Care plan offered without a contract with the Arizonamedicaid program). The contract renews each year. At the end of each year, the contract is reviewed, and CIGNA HealthCare of Arizona, Inc. or the Centers for Medicare & Medicaid Services (CMS) can decide to end it. You will get 90 day 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.
Under what conditions can CIGNA end your membership and make you leave the plan?We cannot ask you to leave the plan because of your health. No customer of any Medicare health 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 plan because of your health, you should call 1-800-MEDICARE (1-800-633-4227) (TTY/TDD users should call 1-877-486-2048). This number is available 7 days a week, 24 hours a day.
We can ask you to leave the plan under certain special conditions. If any of the following situations occur, we will need to end your membership in the CIGNA Medicare Select Plus Rx plan.
- If you move out of our geographic service area or live outside the plan's service area for more than six months at a time.
- If you do not stay continuously enrolled in both Medicare Part A and Medicare Part B. If you only have Part B, you must stay continuously enrolled in Medicare Part B.
- If you behave in a way that is unruly, uncooperative, threatening, disruptive, or abusive, and this behavior seriously affects our ability to arrange or provide medical care for you or for others who are members of a CIGNA Medicare plan. We cannot make you leave CIGNA Medicare Select Plus Rx for this reason unless we get permission first from the Centers for Medicare & Medicaid Services.
- If you let someone else use your plan membership card to get medical care. Before we ask you to leave CIGNA for this reason, we must refer your case to the Inspector General, and this may result in criminal prosecution.
- If you fail to pay your monthly CIGNA Medicare Select Plus Rx plan medical premium, if any. We will notify you in writing prior to ending your coverage.
- If you are amember of a CIGNA Medicare Select Plus Rx special needs plan and you lose your special needs status.
You have the right to make a complaint if we ask you to leave a CIGNA Medicare plan.
If we ask you to leave CIGNA Medicare Select Plus Rx, we will tell you our reasons in writing and explain how you can file a complaint against us if you want to.