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Member rights and disenrollment

PLEASE NOTE THESE IMPORTANT POINTS

  • If Sharp Advantage ends your membership involuntarily, we will send you notification telling you our reasons.
  • If you disenroll from our plan voluntarily we will send you a confirmation letter acknowledging the receipt of your request and stating the effective date of your disenrollment
  • You have the right to make a complaint if we end your membership in our Plan.
  • Voluntarily ending your membership
  • Involuntarily ending your membership
Voluntarily ending your membership

You can voluntarily disenroll from Sharp Advantage by submitting a written notification requesting to disenroll from our plan. Please include your name and member ID on the written letter and mail it to: Enrollment/Disenrollment, PO Box 3358, Scranton, PA 18505. You can also call 1-800-MEDICARE or switch to another Medicare organization. If you disenroll by calling 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week, or consult www.medicare.gov or switch to another Medicare organization, you do not need to submit written notification to Sharp Advantage. Your membership will end automatically once we receive the notification from Medicare. Once notification of the disenrollment request is received, typically your membership will end the first of the following month after the request is received.

If you leave our plan, 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 until your disenrollment goes into effect and your Sharp Advantage coverage ends.


Involuntarily ending your membership

Involuntary disenrollment means that Sharp Advantage can disenroll you from the plan if the following situations occur:

  • If you no longer meet the eligibility requirements to remain a member of Sharp Advantage.
  • If you engage in disruptive behavior, to the extent that your continued enrollment seriously impairs the ability to arrange or provide medical care for you or for others who are members of the Plan.
  • If you provide fraudulent information on an enrollment request
  • If you permit abuse of an enrollment card by letting someone else use your medical ID card. If you are disenrolled for this reason, the Centers for Medicare and Medicaid Services (CMS) may refer your case to the Inspector General for additional investigation.


 

Sharp Advantage is offered by Sharp Health Plan. Sharp Advantage is an HMO plan with a Medicare contract. Enrollment in Sharp Advantage depends on contract renewal. Read the full disclaimer.

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Page Last Updated: 10/01/2016