Disenrollment

• Medicare members may disenroll from the plan when the guidelines, as set forth by CMS, are met.

• Refer members to the ConnectiCare Member Services Department at 1-800-CCI-CARE (1-800-224-2273) if they need information on disenrollment.

• We hope that our members are satisfied and decide to stay with ConnectiCare; however, should you learn that a member plans to disenroll, you may avoid payment delays by:

1. Reminding the patient to notify ConnectiCare; and
2. Asking at the time of each visit if he/she is still enrolled in a ConnectiCare Plan.

ConnectiCare Involuntary Disenrollment
Each member’s enrollment is generally in effect as long as the member chooses to stay in ConnectiCare. The Plan cannot and will not disenroll a member because of the amount or cost of services used. However, ConnectiCare must terminate members for the following:

• The member has a change of address outside the service area.
• The member loses entitlement to Medicare Parts A and/or B.
• The plan contract is terminated.

Additionally, ConnectiCare may disenroll a member if:

• Premiums are not paid on a timely basis.
• the member engages in disruptive behavior.
• The member provides fraudulent information on the application or permits abuse of an enrollment card.