Disenrollment Rights & Responsibilities
When your enrollment in a Medicare plan ends, it’s called disenrollment.
When YOU choose to end your coverage, it’s called voluntary disenrollment. You are allowed to
voluntarily disenroll only during certain times of the year, such as the annual open enrollment period.
When your coverage ends for another reason, it’s called involuntary disenrollment. Why would your
coverage end involuntarily? If you leave your plan’s service area [within six months for HMO plans or
12 months for PPO or prescription drug plans (PDPs)] or fail to pay your plan premium, you may be
disenrolled involuntarily.
You will be notified if you are being disenrolled from a plan—whether it is a voluntary or involuntary
disenrollment. The reason for disenrollment and the date your coverage ends will be included in the
notification.
If you’d like to voluntarily disenroll from your plan or have questions about disenrollment, contact
Medicare or BCBSAZ:
For Medicare Advantage (MAPD)
Blue Cross Blue Shield of Arizona
P.O. Box 29234
Phoenix, AZ 85038-9234
Call Medicare to disenroll:
1-800-633-4227 (TTY: 1-877-486-2048)
24 hours a day, seven days a week
For Blue MedicareRx (PDP)
Blue MedicareRx (PDP) for Arizona
P.O. Box 3777
Scranton, PA 18505
Call Medicare to disenroll:
1-800-633-4227 (TTY: 1-877-486-2048)
24 hours a day, seven days a week
Your rights and responsibilities when disenrolling
Federal law requires the following protections, but your state may have laws that provide additional
Medigap protections. If you will be changing to Original Medicare, you may 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 six months,
or if you move out of the service area, you may have this special right. If you have questions about
Medigap or Medigap rights in Arizona, contact the Arizona State Health Insurance Program.
We cannot ask you to leave your health plan for health-related
reasons
If you feel that you are being encouraged or asked to leave your Plan because of your health, call the
national Medicare help line at 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048.
Assistance is available 24 hours a day, 7 days a week.
If we end your membership involuntarily, we will send you notification telling you the reason and what
to do if you disagree with our decision.
You have the right to file a complaint with Medicare if we end your membership in our Plan. Please
contact them at the information above or visit their website.