How to Disenroll

Disenrollment means that you are ending your membership with TexanPlus^® HMO. Disenrollment can be voluntary (your choice) or involuntary (not your choice). Let's discuss each below:

Involuntary Disenrollment

An involuntary disenrollment from your current Medicare Advantage plan means that you did not request disenrollment but the plan had to disenroll you due to a certain circumstance.

Examples of an Involuntary Disenrollment are:

• A change in residence that is outside of your current plans service area.
• You lose entitlement to Medicare Part A or Part B
• You become incarcerated
• You pass away
• You are enrolled in our Tribute^® HMO Special Needs Plan (SNP) and no longer qualify for enrollment.

In situations where we must disenroll you, a letter notifying you of the disenrollment, the effective date of the disenrollment and your next steps will be mailed to you.

Voluntary Disenrollment

A voluntary disenrollment from your current Medicare Advantage plan means that you submitted a written request for disenrollment and you met a valid election period to disenroll.

All voluntary disenrollment requests require a written and signed notice from you and must be submitted during a valid Medicare election period.

Let's review how to voluntarily disenroll from each plan type:

• How to Voluntarily Disenroll from a Medicare Advantage Prescription Drug Plan (MA-PD)

  If you decide you want to disenroll from your current MA-PD plan, Medicare has two election periods a year in which you can disenroll from your plan for any reason. These two times of year are:

  • The Annual Election Period (AEP) which extends from October 15, 2011 - December 7, 2011 or
  • The Medicare Advantage Disenrollment Period (MADP) which extends from January 1, 2012 - February 14, 2012.

  In order to disenroll outside of these periods, you will need a valid Special Election Period (SEP). SEPs are periods outside of the AEP and MADP in which an individual may elect to enroll in a plan or change his or her current plan election.

  • For Example:

    In certain cases, such as if you move or enter an assisted living, nursing home, receive Extra Help paying for your prescription drugs or you have Medicare and Medicaid, you may be able to disenroll from your plan before the end of the year.

  To disenroll from our plan, you must submit a written request to the plan. Your disenrollment request should be mailed to:
  • TexanPlus
  • P.O. Box 740445
  • Houston, TX 77274
  • By Fax: 1-866-503-8428

  After we receive your written disenrollment request, we will determine if you are eligible to disenroll from the plan. If you are eligible to disenroll, TexanPlus will let you know, in writing, the date your coverage will end.

  While you are waiting for your membership in the plan to end, you are still a member and must continue to obtain your prescription drugs through TexanPlus network pharmacies. In most cases, your prescriptions are covered only if they are filled at a network pharmacy that is listed in our pharmacy directory and you follow other plan rules.

  If you don't receive a letter notifying you of your disenrollment, please call us at 1-800-958-2707, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 1-800-958-2692) 7 days a week and ask for the date in which your coverage ended.

  If you have any questions about your prescription drug coverage with TexanPlus, please call us at 1-800-958-2707, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 1-800-958-2692) 7 days a week.

• How to Voluntarily Disenroll from a Medicare Advantage Plan without Prescription Drug Coverage

  If you have a Medicare Advantage plan without prescription drug coverage and decide you want to disenroll from your current plan, Medicare has two election periods a year in which you can disenroll from your plan for any reason. The two times of year are:

  • The Annual Election Period (AEP) which extends from October 15, 2011 - December 7, 2011 or
  • The Medicare Advantage Disenrollment Period (MADP) which extends from January 1, 2012 – February 14, 2012.

  In order to disenroll outside of these periods, you will need a valid Special Election Period. SEPs are periods outside of the AEP and MADP when an individual may elect to enroll in a plan or change his or her current plan election.

• For Example:

  In certain cases, such as if you move or enter an assisted living, nursing home, or you have Medicare and Medicaid you may be able to disenroll from your plan before the end of the year.

To disenroll from our plan, you must submit a written request to the plan. Your disenrollment request should be mailed to:

• TexanPlus
• P.O. Box 740445
• Houston, TX 77274
• By fax: 1-866-503-8428

After we receive your written disenrollment request, we will determine if you are eligible to disenroll from the plan. If you are eligible to disenroll from the plan, TexanPlus will let you know, in writing, the date in which your coverage will end.

For additional assistance, please call us at 1-800-958-2707, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 1-800-958-2692) 7 days a week Or, you can call 1-800-MEDICARE (1-800-633-4227) (TTY/TDD users call 1-877-486-2048) 24 hours a day/7 days a week or visit www.medicare.gov (by clicking on this link you will be leaving our website).

Involuntary Termination of Coverage due to Contract Termination

In the unlikely event your Plan Sponsor leaves the Medicare program, or no longer offers prescription drug coverage in the service area where you live (if you have a Medicare Advantage Prescription Drug plan), we will notify you in writing.

If this happens, your membership in TexanPlus will end, and you will need to enroll in another Medicare Advantage Plan to continue your coverage. All of the benefits and rules of TexanPlus would continue until the effective date of your membership in TexanPlus ends.

If TexanPlus leaves the Medicare program or your service area; you would need to select another plan. Your choices would include joining another Medicare Prescription Drug Plan (MA-PD) or a Medicare Advantage Plan without prescription drug coverage, if these plans are available in your area and are accepting new members. As soon as TexanPlus has notified you in writing that they are leaving the Medicare program or the area where you live, you may enroll in another plan.

The Plan Sponsor is contracted with the Centers for Medicare & Medicaid Services (CMS), the government agency that runs oversees Medicare. This contract is subject to renewal each year. However, the Plan Sponsor or CMS can decide to end the contract at any time. You will generally be notified 90 days in advance if this situation occurs. However, your advance notice may be as little as 30 days or fewer if CMS must end the contract in the middle of the year.