Rights and Responsibilities Upon Disenrollment

We hope you don’t leave SCAN, but if you do, there are some things you should know.

It may take time before your membership ends and your new Medicare coverage goes into effect. During this time, you must continue to get your medical care and prescription drugs
through our plan.

• You should continue to use our network pharmacies to get your prescriptions filled until your membership in our plan ends. Usually, your prescription drugs are only covered if they are filled at a network pharmacy including through our mail-order pharmacy services

• If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins). In addition, you may want to tell your doctor that there may be a short delay in updating your records if he needs to send Medicare claims, since you recently disenrolled from SCAN Health Plan.

Finally, if your SCAN Health Plan premium is being deducted from your Social Security benefit, please allow up to 3 months for us to process a refund. If you have not received a refund from Social Security within 3 months of this letter, you should contact 1-800-MEDICARE.

INFORMATION ABOUT MEDIGAP RIGHTS 
If you will be changing to Original Medicare you might have a special temporary right to buy a Medigap policy, also known as Medicare supplement insurance, even if you have health problems. For example, if you are age 65 or older and you enrolled in Medicare Part B within the past 6 months or if you move out of the service area, you may have this special right. Federal law requires the protections described above. Your State may have laws that provide more Medigap protections.

If you have questions about Medigap or Medigap rights in your State, you should contact your State Health Insurance Program Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222. You can also call 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, 7 days a week for more information. TTY users should call 1-877-486-2048. 

If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can file a grievance or make a complaint about our decision to end your membership. Call Member Services or see your Evidence of Coverage for more information about ending your membership in SCAN Health Plan.