Disenrollment Rights and Responsibilities

Information on enrollees’ and plans’ rights and responsibilities upon disenrollment

As a Leon Health, Inc. member, you have rights and responsibilities upon ending your enrollment from the plan.

You have the right to end your enrollment from the plan during specific periods in the year. These periods are as follows:

  • The annual Enrollment Period is once a year, from October 15 to December 7. During this period, your enrollment in the plan will end on January 1 of the following year.
  • The annual Medicare Advantage Open Enrollment Period is also once a year, from January 1 to March 31. During this period, your enrollment will end the month following the date you submitted the request to end your enrollment into the plan.
  • You can also end your enrollment in the plan outside of this period for specific situations. These are some examples of situations where you can end your enrollment outside of the above periods.
    • Usually, when you have moved.
    • If you have Medicaid.
    • If you are eligible for “Extra Help” with paying for your Medicare prescriptions.
    • If we violate our contract with you.
    • If you are getting care in an institution, such as a nursing home or long-term care (LTC) hospital.
    • If you enroll in the Program of All-inclusive Care for the Elderly (PACE).

Ending your enrollment with the plan will change to Original Medicare, you might have a special temporary right to buy a Medigap (Medicare supplement insurance) policy, 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 particular right. Federal law requires the protections described above. In addition, your state may have laws that provide more Medigap protections. If you have questions about Medigap or Medigap rights in your State, you should contact your State Health Insurance Program. You can also call 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, seven days a week, for more information. TTY users should call 1-877-486-2048.

If we end your membership in our plan and We must also explain how you can file a grievance or complain about our decision to end your membership. You can look in your Evidence of Coverage for information about how to make a complaint.

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