Disenrollment from Blue
MedicareRx (PDP)

You have the right to disenroll from your Medicare Part D plan. If you choose to disenroll from Blue MedicareRx (PDP), that means you are canceling your Medicare prescription drug coverage with us.

Time periods for disenrollment

Medicare rules allow you to disenroll from a Part D plan during the same time periods that enrollment is allowed:

About voluntary disenrollment

You may only request disenrollment from Blue MedicareRx (PDP) during one of the periods listed above. You can disenroll by:

  • Enrolling in another Part D plan during a valid enrollment period
  • Faxing or mailing a signed disenrollment form to Blue MedicareRx
  • Calling 1-800-MEDICARE

After we receive your disenrollment form, we will let you know if you can disenroll at that time. If you can, we will notify you of the effective date of your disenrollment. After that date, we will not cover any prescription drugs you receive.

Please note: While you are waiting for your effective date of disenrollment, you are still a Blue MedicareRx (PDP) member. To use your plan benefits, you must continue to get your prescription drugs through one of our network pharmacies and follow all other plan rules.

About involuntary disenrollment

We cannot ask you to leave our plan for any health-related reasons. If you ever think you are being encouraged or asked to disenroll because of your health, you should call 1-800-MEDICARE (1-800-633-4227), which is the national Medicare help line. TTY/TDD users should call 1-877-486-2048. You may call 24 hours a day, 7 days a week.

However, you can be involuntarily disenrolled from our plan if:

  • You do not stay continuously enrolled in either Medicare Part A or Part B.
  • You move out of our service area or are away from our service area for more than 6 months. If you plan to move or take a long trip, please call Customer Care to find out if the place you are moving to or traveling to is in our service area.
  • You knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drugs.
  • You do not pay our plan premiums. You will be notified in writing that you have a grace period during which to pay before your membership ends.

You have the right to ask us to reconsider a disenrollment decision by filing a grievance.

Contract Termination

The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed. Our plan is required to notify beneficiaries that it is authorized by law to refuse to renew its contract with the Centers for Medicare & Medicaid Services (CMS), that CMS also may refuse to renew the contract, and that termination or non-renewal may result in termination of your enrollment. In addition, the plan may reduce its service area and no longer offer services in the area where you reside. In the event this happens, you will receive advance notice.
Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment, service areas and any applicable conditions associated with using the plan benefits. For full information on benefits, please call Customer Care.

If you have questions

If you have any questions about disenrolling, please Contact Us , 24 hours a day, 7 days a week.

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