• Fallon Medicare Plus - Plan Year 2025
• • Shop for a plan
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  • • Benefit Bank
    • Care management programs
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    • Extras and discounts
    • Coverage decisions, appeals, and grievances
    • Getting care during a disaster
    • Authorization requirements, coverage criteria, and policies
    • Online resources
    • Ending your membership
  • Fallon Medicare Plus - Plan Year 2024
• Medicare Supplement
• NaviCare

Ending your membership

Ending your membership in Fallon Medicare Plus may be voluntary (your own choice) or involuntary (not your own choice).

You might leave our plan because you've decided that you want to leave. You may end your membership in our plan only during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Election Period and during the Medicare Advantage Open Enrollment Period. In certain situations, you may also be eligible to leave the plan at other times of the year. 

In some cases, we must end your membership in the plan. We're not allowed to ask you to leave our plan for any reason related to your health. If you feel that you're being asked to leave our plan because of 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.

If you leave Fallon Medicare Plus, 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.

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.

We must end your membership in the plan if any of the following happen:

• You no longer have Medicare Part A and Part B.
• You move out of our service area.
• You're away from our service area for more than 6 months.
• You become incarcerated (go to prison).
• You're not a United States citizen or lawfully present in the United States.
• You lie about or withhold information about other insurance you have that provides prescription drug coverage.
• You intentionally give us incorrect information when you're enrolling in our plan and that information affects your eligibility for our plan. (We can't make you leave our plan for this reason unless we get permission from Medicare first.)
• 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. (We can't make you leave our plan for this reason unless we get permission from Medicare first.)
• You let someone else use your membership card to get medical care. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.)
• You don't pay the plan premiums for 2 calendar months.
• You're required to pay the extra Part D amount because of your income and you don't pay it, Medicare will disenroll you from our plan and you'll lose prescription drug coverage.

You can find more information about ending your membership in your Evidence of Coverage in the chapter called, "Ending your membership in the plan."