If you wish to disenroll from the plan, you may do so by mailing or faxingMeridian Advantage Plan of Michigan
a signed written notice expressing your intent to disenroll (you may use the disenrollment form provided below to serve as your written notice). Additionally, if you enroll in another Medicare Advantage or Medicare Prescription Drug Plan, Medicare will cancel your current membership inMeridian Advantage Plan of Michigan
on the effective date of your new enrollment.
There are limited times during the year in which individuals are able to disenroll and/or join other Medicare Advantage or Medicare prescription drug plans, unless you qualify for special circumstances, known as Special Enrollment Periods.
Meridian Advantage Plan of Michigan
will notify you of your disenrollment effective date after we receive approval of your disenrollment from the Centers for Medicare & Medicaid Services (CMS). You must continue to get all medical care fromMeridian Advantage Plan of Michigan
until the effective date of disenrollment. You can contact us at the phone number provided below to verify your disenrollment before you seek medical services outside of theMeridian Advantage Plan of Michigan
If you disenroll fromMeridian Advantage Plan of Michigan
you will be disenrolling from your Medicare Advantage and your Medicare prescription drug coverage If you do not enroll in another Medicare prescription drug plan or Medicare Advantage plan with prescription drug coverage, or have other coverage as good as Medicare, you may have to pay a penalty for this coverage in the future.
If you have questions about your disenrollment, or if you would like more information about your rights and responsibilities upon disenrollment, please contact Member Services at877-902-6784 (TTY 711), Monday - Sunday from 8 a.m. - 8 p.m.
Page Last Modified: 2/3/2016 2:46:23 PM