Disenrollment

When can you end your membership (disenroll) in AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid plan)?

You can end your membership in AmeriHealth Caritas VIP Care Plus at any time. The change will be effective the first day of the next month after we get your request. Note: If you're in a drug management program, you may not be able to change plans. See Chapter 5 of the Member Handbook (PDF) for information about drug management programs.

How do I end my membership in your plan?

If you decide to end your membership, tell Michigan Medicaid or Medicare that you want to leave AmeriHealth Caritas VIP Care Plus. You can either:

• Call Michigan ENROLLS at 1-800-975-7630 (TTY 1-888-263-5897). The office hours are Monday through Friday, 8 a.m. to 7 p.m.
• Call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048), 24 hours a day, seven days a week. When you call 1-800-MEDICARE, you can also enroll in another Medicare health or drug plan.

How do I join a different plan?

If you want to keep getting your Medicare and Michigan Medicaid benefits together from a single plan, you can join a different Medicare-Medicaid plan.

To enroll in a different Medicare-Medicaid plan:

• Call Michigan ENROLLS at 1-800-975-7630 (TTY 1-888-263-5897), 8 a.m. to 7 p.m., Monday through Friday. Tell them you want to leave AmeriHealth Caritas VIP Care Plus and join a different Medicare-Medicaid plan. If you are not sure what plan you want to join, they can tell you about other plans in your area.
• Send Michigan ENROLLS an Enrollment Change Form. You can get the form mailed to you by calling Michigan ENROLLS at 1-800-975-7630.

If I leave your plan and I do not want a different Medicare-Medicaid plan, how do I get Medicare and Michigan Medicaid services?

If you do not want to enroll in a different Medicare-Medicaid plan after you leave AmeriHealth Caritas VIP Care Plus, contact Michigan ENROLLS at 1-800-975-7630 (TTY 1-888-263-5897), 8 a.m. to 7 p.m., Monday through Friday. You can disenroll and can go back to getting your Medicare and Michigan Medicaid services.

How will I get Medicare services?

You will have a choice about how you get your Medicare benefits. You have three options for getting your Medicare services. By choosing one of these options, you will automatically end your membership in our plan.

• You can change to a Medicare health plan, such as a Medicare Advantage plan or Program of All-Inclusive Care for the Elderly (PACE).
• You can change to original Medicare with a separate Medicare prescription drug plan.
• You can change to original Medicare without a separate Medicare prescription drug plan.

NOTE: If you switch to original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you tell Medicare you don't want to join. You should only drop prescription drug coverage if you get drug coverage from an employer, union, or other source. If you have questions about whether you need drug coverage, call your Michigan Medicare/Medicaid Assistance Program (MMAP) at 1-800-803-7174.

Here is what to do:

Call Medicare at 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), 24 hours a day, seven days a week, to enroll in the new Medicare-only health plan.

For help or more information:

Call the State Health Insurance Assistance Program (SHIP). In Michigan, SHIP is called the Michigan Medicare/Medicaid Assistance Program (MMAP). MMAP can be reached at 1-800-803-7174.

You will automatically be disenrolled from AmeriHealth Caritas VIP Care Plus when your new plan or original Medicare coverage begins.

How will I get Michigan Medicaid services?

If you leave a Medicare-Medicaid plan, you will get your Michigan Medicaid services through fee-for-service. Your Michigan Medicaid services include most long-term services and supports and behavioral health care. If you leave a Medicare-Medicaid plan, you can see any provider that accepts Michigan Medicaid.

Until my membership ends, will I keep getting my medical services and drugs through your plan?

If you leave AmeriHealth Caritas VIP Care Plus, it may take time before your membership ends and your new Medicare and Michigan Medicaid coverage begins. During this time, you will keep getting your health care and drugs through our plan.

How can AmeriHealth Caritas VIP Care Plus end my membership?

These are the cases when AmeriHealth Caritas VIP Care Plus must end your membership in the plan:

• If there is a break in your Medicare Part A and Part B coverage.
• If you no longer qualify for Michigan Medicaid. Our plan is for people who qualify for both Medicare and Michigan Medicaid.
• If you move out of our service area.
• If you are away from our service area for more than six months.
  • If you move or take a long trip, you need to call Member Services to find out if the place you are moving or traveling to is in our plan's service area.
• If you go to prison.
• If you lie about or withhold information about other insurance you have for prescription drugs.

We can make you leave our plan for the following reasons only if we get permission from Medicare and Michigan Medicaid first:

• If you intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan.
• If you continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan.
• If you let someone else use your ID card to get medical care.
  • If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.

We cannot ask you to leave our plan for any reason related to your health. If you feel that you are being asked to leave our plan for a health-related reason, you should call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048), 24 hours a day, seven days a week. You can also call the Beneficiary Help Line at 1-800-642-3195 (TTY 1-866-501-5656), Monday through Friday, 8 a.m. to 7 p.m. You should also call the MI Health Link Ombudsman program at 1-888-746-6456 or 1-888-746-MHLO, Monday through Friday from 8 a.m. to 5 p.m.

Your right to make a complaint if we end your membership in our plan

If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. You may file a grievance or make a complaint about our decision to end your membership. For more information on how to file a grievance, you may also see Chapter 9 of the Member Handbook (PDF) or call Member Services at 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m., seven days a week.

Where can I get more information about ending my plan membership?

If you have questions or would like more information on when we can end your membership, see chapter 10 of the Member Handbook (PDF). You can also call Member Services at 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m., seven days a week.