Disenrollment Information

When can you end your membership in our Medicare-Medicaid plan?

You can end your membership in Cigna-HealthSpring CarePlan Medicare-Medicaid Plan at any time. Your membership will end on the last day of the month that we get your request to change your plan. For example, if we get your request on January 18, your coverage with our plan will end on January 31. Your new coverage will begin the first day of the next month.

These are ways you can get more information about when you can end your membership:

How do you end your membership in our plan?

If you decide to end your membership, tell Medicaid or Medicare that you want to leave Cigna-HealthSpring CarePlan:

How do you join a different Medicare-Medicaid plan?

If you want to keep getting your Medicare and Medicaid benefits together from a single plan, you can join a different Medicare-Medicaid plan.

To enroll in a different Medicare-Medicaid plan:

  • Call Maximus at 1 (877) 782-6440, Monday – Friday, 8:00 am – 8:00 pm Central time. TTY users should call 1 (877) 486-2048. Tell them you want to leave Cigna-HealthSpring CarePlan and join a different Medicare-Medicaid plan. If you are not sure what plan you want to join, they can tell you about other plans in your area; OR
  • Send Maximus a disenrollment form. You can get the form by calling Maximus at 1 (877) 782-6440 (TTY 1 (877) 486-2048) if you need them to mail you one.

Your coverage with Cigna-HealthSpring CarePlan will end on the last day of the month that we get your request.

If you leave our plan and you do not want a different Medicare-Medicaid plan, how do you get Medicare and Medicaid services?

If you do not want to enroll in a different Medicare-Medicaid plan after you leave Cigna-HealthSpring CarePlan, you will go back to getting your Medicare and Medicaid services separately.

How you will get Medicare services

You will have a choice about how you get your Medicare benefits. You have three options for getting your Medicare services. By choosing one of these options, you will automatically end your membership in our plan.

You can change to:Here is what to do:

A Medicare health plan, such as a Medicare Advantage plan or Programs of All-inclusive Care for the Elderly (PACE)

Call Medicare at 1 (800) MEDICARE (1 (800) 633-4227), 24 hours a day, 7 days a week. TTY users should call 1 (877) 486-2048 to enroll in the new Medicare-only health plan.

If you need help or more information:

  • Call the State Health Insurance Assistance Program (SHIP) at 1 (800) 252-3439 (TTY 1 (866) 323-5321). In Texas, the SHIP is called the Health Information Counseling & Advocacy Program of Texas (HICAP).

You will automatically be disenrolled from Cigna-HealthSpring CarePlan when your new plan’s coverage begins.

Original Medicare with a separate Medicare prescription drug plan

Call Medicare at 1 (800) MEDICARE (1 (800) 633-4227), 24 hours a day, 7 days a week. TTY users should call 1 (877) 486-2048.

If you need help or more information:

  • Call the State Health Insurance Assistance Program (SHIP) at (800) 252-3439 (TTY 1 (866) 323-5321). In Texas, the SHIP is called the Health Information Counseling & Advocacy Program of Texas (HICAP).

You will automatically be disenrolled from Cigna-HealthSpring CarePlan when your Original Medicare coverage begins.

Original Medicare without a separate Medicare prescription drug plan

NOTE: If you switch to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you tell Medicare you don’t want to join.

You should only drop prescription drug coverage if you get drug coverage from an employer, union or other source. If you have questions about whether you need drug coverage, call Health Information Counseling & Advocacy Program of Texas (HICAP) at 1 (800) 252-3439.

Call Medicare at 1 (800) MEDICARE (1 (800) 633-4227), 24 hours a day, 7 days a week. TTY users should call 1 (877) 486-2048.

If you need help or more information:

  • Call the State Health Insurance Assistance Program (SHIP) at 1(800) 252-3439 (TTY 1 (866) 323-5321). In Texas, the SHIP is called the Health Information Counseling & Advocacy Program of Texas (HICAP).

You will automatically be disenrolled from Cigna-HealthSpring CarePlan when your Original Medicare coverage begins.

How you will get Medicaid services

If you leave the Medicare-Medicaid plan, you will remain in our plan to get your Medicaid services. Your Medicaid services include most long-term services and supports and behavioral health care.

If you leave the Medicare-Medicaid plan, you will remain with Cigna-HealthSpring CarePlan to receive your Medicaid services.

You can choose to switch to another Medicaid-only health plan by contacting Maximus at 1 (877) 782-6440, Monday - Friday, 8:00 am - 8:00 pm Central Time. TTY users should call 1 (877) 486-2048. You will get a new member ID card, a new Member Handbook, and a new Provider and Pharmacy Directory.

Until your membership ends, you will keep getting your medical services and drugs through our plan

If you leave Cigna-HealthSpring CarePlan, it may take time before your membership ends and your new Medicare and Medicaid coverage begins. During this time, you will keep getting your health care and drugs through our plan.

  • You should use our network pharmacies to get your prescriptions filled. Usually, your prescription drugs are covered only 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. This will happen even if your new health coverage begins before you are discharged.

Your membership will end in certain situations

These are the cases when Cigna-HealthSpring CarePlan must end your membership in the plan:

  • If there is a break in your Medicare Part A and Part B coverage.
  • If you no longer qualify for Medicaid. Our plan is for people who qualify for both Medicare and Medicaid.
  • If you move out of our service area.
  • If you are away from our service area for more than six months.
    • If you move or take a long trip, you need to call Member Services to find out if the place you are moving or traveling to is in our plan’s service area.
  • If you go to prison.
  • If you lie about or withhold information about other insurance you have for prescription drugs.

We can make you leave our plan for the following reasons only if we get permission from Medicare and Medicaid first:

  • If you intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan.
  • If you continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan.
  • If you let someone else use your ID card to get medical care.
    • If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.

We cannot ask you to leave our plan for any reason related to your health

If you feel that you are being asked to leave our plan for a health-related reason, you should call Medicare at 1-800-MEDICARE (1 (800) 633-4227). TTY users should call 1 (877) 486-2048. You may call 24 hours a day, 7 days a week. You should also call Texas Medicaid at 1 (800) 252-8263 or 211 (TTY users should use 1 (800) 735-2989 or 711).

You have the right to make a complaint if we end your membership in our plan

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 make a complaint about our decision to end your membership.

Where can you get more information about ending your plan membership?

If you have questions or would like more information on when we can end your membership, you can call Member Services at 1 (877) 653-0327 (TTY 711) 8:00 am – 8:00 pm Central time, 7 days a week.