Disenrollment

If you decide to switch to Medicare Original, you might have a special temporary right to buy a Medigap policy, also known as Medicare supplement insurance, even if you have health problems. For example, if you are age 65 or older and you enrolled in Medicare Part B within the past 6 months or if you move out of the service area, you may have this special right. Federal law requires the protections described above. Puerto Rico may have laws that provide more Medigap protections.

If you have questions about Medigap or any special temporary rights you may have, you should contact the Puerto Rico Health Insurance Assistance Program, also called the Office for the Ombudsman for Retirees and the Elderly at 1-877-725-4300 or 787-721-6121. You can also call 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day / 7 days a week for more information. TTY users should call 1-877-486-2048.

• If you were enrolled in another Medicare Advantage or Medicare Prescription Drug Plan and then you enrolled with our plan you may appear on their records as being disenrolled. If your intent is to remain a member of the previous plan:
  • You will need to cancel your enrollment with us, before your membership in our plan becomes effective.
  • You will need to notify them that you enrolled in our plan but have cancelled your enrollment. They may request a letter from our plan for their records.
• Please note that if you do not obtain a Medicare Prescription Drug Coverage or other creditable prescription drug coverage when you become eligible, or if you stay without creditable prescription drug coverage for 63 consecutive days or more, you may have to pay a late enrollment penalty if you enroll in Medicare Prescription Drug Coverage in the future.
• If you feel that you are being asked to leave our plan because of a health-related reason, you have the right to file a complaint with Medicare.
• If we end your membership in our plan and you do not agree with our decision, you have the right to file a complaint with us.
• If you disenroll, remember the following during the disenrollment process:
  • Until your membership ends, you must continue getting your medical services and/or drugs through our plan. That means you can’t disenroll on a Monday and expect to be on a new plan on Tuesday. You must continue to get your medical care and/or prescription drugs through our plan until the end of the month, when the disenrollment is effective.
  • If your plan includes prescription drug coverage, you should continue to use our network pharmacies to get your prescription drugs filled until your membership in our plan ends.
  • If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins).

For more information on the disenrollment process, please refer to your plan’s Evidence of Coverage (under “Ending your membership in the plan”), call Member Services, or call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week for more information. TTY users can call 1-877-486-2048.