Medicare Advantage & Part D Disenrollment Requests Through 1-800-MEDICARE (CMS-R-257)

Attachment B

Overview of 1-800-Medicare Medicare Advantage (MA) and Prescription Drug (Part D) Plan Disenrollment Script

1. The 1-800-MEDICARE call center representative (CSR) determines if the beneficiary (or authorized representative) is eligible for a valid enrollment period to disenroll from a MA or Part D plan.

2. If eligible to disenroll, CSR determines whether the individual has joined another MA or Part D plan.

1. If the individual has joined a new plan, CSR advises the individual that a disenrollment request is not needed. The enrollment in another MA or PDP will automatically disenroll the individual from his/her current plan. The individual will receive a letter from the new plan confirming the enrollment and a letter from your current plan confirming the disenrollment. The CSR will check the system to see if the disenrollment has been processed. If no date shows, the CSR refers the caller to the new plan to verify his/her enrollment.

2. If individual has not yet joined a new plan and wishes to do so, the individual is advised that a CSR can assist in this process, if requested.

3. If the individual is eligible to disenroll and wants to disenroll from the MA or Part D plan, CSR advises caller that he/she can disenroll.

1. If currently enrolled in an MA plan, CSR advises that the disenrollment from the MA plan will automatically return the individual to Original Medicare.

2. If currently enrolled in an MA plan with Part D or a stand-alone Part D plan, the CSR advises the individual that if he/she disenrolls from Medicare drug coverage and doesn’t join another plan until later, he/she may have to pay a penalty for being without creditable coverage.

4. If the individual confirms that he/she wants to disenroll, the CSR indicates that a disenrollment request will be submitted for the specific plan. The CSR advises the individual both of the disenrollment effective date and of the need to keep using the current plan until the disenrollment effective date. After the disenrollment date, the current plan will no longer cover prescription drug or health care costs. It normally takes about 15 business days to completely process the disenrollment request. The individual will receive a letter confirming the request has been processed.

5. The CSR further advises the individual that if he/she wants to cancel the disenrollment request, he/she must do so prior to the effective date of disenrollment. Once the disenrollment is effective, the individual will need to wait until the next valid enrollment period to make additional changes, unless he/she qualifies for a special enrollment period (e.g. change of permanent residence).

6. If the caller decides in the future that he/she wants a Medicare drug plan, he/she can enroll in a new plan during a valid enrollment period.