Page 99

98 | P a g e

60 – Disenrollment 42 CFR §§ 422.66, 422.74, 423.36, and 423.44

Except as provided by law and described in this section, plans may not, either orally or in writing, or by any action or inaction, request or encourage any individual to disenroll from a plan. Plans may contact individuals to determine the reason for disenrollment; however, they must not discourage individuals from disenrolling. Consistent with prohibitions on discrimination for federal healthcare programs and in sections 1851(g), 1852(b), and 1860D- 1(b)(1)(B)(v) of the Act, plans must apply disenrollment policies in a consistent manner for all enrollees.

60.1 – Voluntary Disenrollment 42 CFR §§ 422.66(b)(1), 422.74, and 423.36

Voluntary disenrollment can only be initiated by the enrollee or the enrollee’s authorized representative as recognized by State laws (see § 50.1 for who may complete an enrollment or disenrollment request) during a valid election period (refer to § 30 on election periods). Individuals may voluntarily disenroll from a plan by: • Enrolling in another plan (during a valid election period); • Mailing or faxing a signed notice of disenrollment to the plan, or to the individual’s employer/union group, where applicable; • Submitting an electronic request via the plan’s secure internet website (if the plan offers such an option); or • Calling 1-800-MEDICARE.

If an enrollee verbally requests disenrollment from a plan, the plan must instruct the individual to make the request via one of the methods outlined above. The plan may send a disenrollment form to the individual upon request (see MA Exhibits 9, 9a, 10, and 10a;Part D Exhibits 8, 9, and 9a).

Plans accepting voluntary disenrollment requests via an electronic mechanism must, at a minimum, comply with the HIPAA data security and privacy policies.

Online disenrollment by other means, such as emailing the plan (including emailing an attachment of the signed notice of disenrollment) or via a broker website, are not permitted.

60.1.1 – Voluntary Disenrollment Processing 42 CFR §§ 422.66 (b)(3), 422.504(e)(4), 423.36, and 423.505(e)(4)

Processing a voluntary disenrollment request begins when a plan receives a disenrollment request from the individual or the individual’s authorized representative and ends with the plan communicating, in writing, whether the individual’s disenrollment request has been accepted or denied. In instances where the individual requests disenrollment directly from the plan, processing the disenrollment includes: