Disenrolling From Your Plan

Guidelines for Leaving the Plan

There may be a time you need to leave your Medicare plan. This means your membership in Blue Cross MedicareRx is ending.

Voluntary Disenrollment — When You Choose to Leave Your Plan

You may end your membership in our plan during certain times of the year, known as enrollment periods.

• All members have the option to leave the plan during the Annual Enrollment Period between October 15 and December 7.
• If you qualify for a Special Enrollment Period, you may be able to leave the plan at other times of the year.

To voluntarily disenroll:

• You must choose to leave the plan.
• You need to provide signed, written notice to Blue Cross MedicareRx. If you enrolled through your employer group, your employer must make the request to disenroll you. You can find details about this in your Evidence of Coverage.
• To learn more, call Customer Service at the number listed on your member ID card. Or call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. If you are hearing or speech impaired, please call 1-877-486-2048.

Involuntary Disenrollment — When You are Removed From Your Plan

There are certain cases when a member must be disenrolled:

• Death of the member.
• A move out of the plan’s service area.
• Member no longer qualifies for Medicare.
• Failure to pay any premiums or late enrollment penalties.
• Member enrolls in a different Medicare Advantage Prescription Drug Plan or stand-alone Medicare Prescription Drug Plan.
• Blue Cross and Blue Shield of Illinois stops offering this plan in the area where it had previously been available.
• Intentionally misrepresent information given to BCBSIL about reimbursement for third-party coverage.