Leaving Aetna Medicare Plan
Leaving a plan
Stay informed about the reasons why your Aetna Medicare coverage could be terminated or why you might be disenrolled. Moving out of the service area, not paying your plan premium, and wanting to change your plan are just a few of the reasons. Choose from the topics below and read on to learn how your benefits would be affected.
- Potential for Coverage Termination
- Potential for Aetna Medicare Contract Termination
- Rights and Responsibilities upon Disenrollment
Potential for Coverage Termination
Your coverage may be terminated for nonpayment of plan premiums (including the applicable plan premium for any Optional Supplemental Benefits you may have chosen). Coverage may also end for other reasons, including but not limited to:
- Terminating employment or losing your group membership (for group members only).
- Permanently moving out of Aetna's service area.
- Fraud or material misrepresentation in enrollment or in the use of services or facilities.
- If you are charged a monthly plan premium (including the additional premium for any Optional Supplemental Benefits you may have elected), you may be disenrolled if you do not pay these premiums.
Prior to disenrolling you, Aetna will advise you that failure to pay these premiums within a 90-day grace period will result in disenrollment from the Aetna Medicare plan you are enrolled in. Aetna may require you to pay any past-due premium amounts. See your plan documents for a complete list of termination of coverage provisions.
Potential for Aetna Medicare Contract Termination
Aetna Medicare has a contract with the Centers for Medicare and Medicaid Services (CMS), the government agency that runs Medicare. This contract may be renewed each year. However, our plan or CMS can decide to end the contract at any time. You will generally be notified in writing 90 days in advance if this situation occurs. However, your advance notice may be as little as 30 days, or even fewer days if CMS must end our contract in the middle of the year.
If Aetna Medicare's contract with CMS ends:
- The benefits and rules described in your Evidence of Coverage will continue until your membership ends.
- You will qualify for a special enrollment period so you can enroll in another Medicare plan to continue your coverage.
See your plan documents for a complete list of termination of coverage and disenrollment provisions.
Rights and Responsibilities upon Disenrollment
"Disenrollment" from an Aetna Medicare plan means ending your membership with us. Disenrollment can be voluntary (your choice) or, in limited circumstances, involuntary (not your choice).
- You might leave one of our plans because you decide that you want to leave. During specified times (November 15 – December 31), you can choose to disenroll from your current Medicare plan.
- Some situations require you to leave. For example, if you move out of our geographic service area, are absent from our service area for more than six consecutive months or if we no longer offer the plan in your geographic area.
Please refer to your Evidence of Coverage for more information, to learn about choices you have after you leave and to review the rules that may apply.
To disenroll, send Aetna a written notice that you'd like to disenroll from your Aetna Medicare plan. Or call 1-800-MEDICARE (TTY/TDD 1-877-486-2048), 24 hours a day, 7 days a week. Members enrolled through a group should also notify their group benefits representative before they disenroll from Aetna.
Your coverage under Original Medicare resumes on the effective date of your disenrollment from your Aetna Medicare plan.
