6. Disenrollment rights

Disenrollment rights + responsibilities

Although we will never disenroll you or ask you to disenroll from our plan due to health-related reasons, there are certain circumstances that will result in your involuntary disenrollment.

Disenrollment may occur if:

  • You do not stay continuously enrolled in Medicare Part A or B (or both).
  • You move out of the service area or are away from the service area for more than six months. (Note: If you plan to move or take a long trip, we encourage you to call Member Services and ask if the place you are moving or traveling to is in the service area.)
  • You knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drug coverage.
  • You continuously behave in a way that is disruptive and makes it difficult for us to provide care for you and other members. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.)
  • You do not pay your monthly premiums; you may be notified in writing that you have a grace period during which you can pay the premiums before your membership ends.
  • Medicare terminates its contract with us or we terminate our contract with Medicare.
  • You are determined to be unlawfully present in the United States.

If you're involuntarily disenrolled, you have the right to ask us to reconsider this decision by filing a grievance with us. If you have any questions about disenrolling from our plan, please call Dean Health Plan by Medica toll-free at 1-877-232-7566 (TTY: 711). Weekdays 8 a.m. - 8 p.m. (year-round) and weekends (Oct. 1 - March 31).

Potential for contract termination

Availability of coverage or service areas beyond the end of the current contract year is not guaranteed. Termination or non-renewal of the contract by Centers for Medicare & Medicaid Services (CMS) or Dean Health Plan as authorized by law may end your enrollment in the plan. If this occurs, you will be able to choose another plan without incurring a late enrollment penalty, as long as you do it within the time period required.