How can I disenroll from a SilverScript Insurance plan?

As a member of SilverScript Insurance, you have a right to disenroll from your Part D plan. If you choose to voluntarily disenroll, you are disenrolling from your Medicare prescription drug coverage. Generally, you may not enroll in a new Plan during other times of the year unless you meet certain special exceptions, such as if you move out of our service area. From November 15 through December 31 each year, you can enroll in a new Medicare Prescription Drug Plan or Medicare Health Plan for the following year.

Medicare allows you to enroll and/or disenroll from a Part D plan during certain times of the year including:

  • The Initial Enrollment Period for Part D
  • The Annual Coordinated Election Period
  • All Special Enrollment Periods

During the Annual Coordinated Election Period and Special Enrollment Periods, individuals may enroll and disenroll from their Medicare Part D plan, or choose another Medicare Part D plan. Individuals may enroll in a plan during the Initial Enrollment Period for Part D. Each individual has one election per enrollment period; once an enrollment or disenrollment becomes effective, the election has been used.

A member may only request disenrollment from SilverScript Insurance during one of the periods listed above. The member may disenroll by:

  • Enrolling in another plan (during a valid enrollment period)
  • Fax or mail a signed disenrollment form to SilverScript Insurance
  • Calling 1-800-MEDICARE

After we receive your disenrollment form, we will let you know if you can disenroll at this time. If you can disenroll, we will also tell you the effective date of your disenrollment. To disenroll you must fill out a disenrollment form, sign it, and send it back to us. After your disenrollment date, we will not cover any prescription drugs you receive.

We cannot ask you to leave your health plan for any health-related reasons. If you ever feel that you are being encouraged or asked to leave our Plan because of your health, you should call 1-800-MEDICARE (1-800-633-4227), which is the national Medicare help line. TTY users should call 1-877-486-2048. You may call 24 hours a day, 7 days a week.

You can be involuntarily disenrolled from our Plan if:

  • You do not stay continuously enrolled in Medicare A or B (or both).
  • You move out of the service area or are away from the service area for more than 6 months you cannot remain a member of our Plan. And we must end your membership ("disenroll" you.) If you plan to move or take a long trip, please call Customer Care to find out if the place you are moving to or traveling to is in our Plan's service area.
  • You knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drug coverage.
  • You do not pay the Plan premiums; you will be notified in writing that you have a grace period during which you may pay the Plan premiums before your membership ends.

You have the right to ask us to reconsider this decision by filing a grievance with us. For more information on the appeals and grievance process, please review your Evidence of Coverage. If you have any questions about disenrolling, please call Enrollment Support from 8:00 a.m. to 2 a.m. EST, 7 days a week at 866-552-6106. TTY users should call 866-552-6288.

Contract Termination
The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed. You are eligible to enroll if you are entitled to Medicare Part A or enrolled in Medicare Part B and you live in the service area. With some exceptions you can only enroll during certain times of the year. For full information on benefits, please call Customer Care.

Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment, service areas and any applicable conditions associated with using the plan benefits.

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