You can end your membership in First Choice VIP Care Plus (Medicare-Medicaid Plan) at any time during the year by enrolling in another Medicare Advantage Plan, enrolling in another Medicare-Medicaid Plan, or moving to Original Medicare. NOTE: Effective January 1, 2019, if you’re in a drug management program, you may not be able to change plans. See Chapter 5, Section G of the Member Handbook (PDF) for information about drug management programs.
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 October 18, your coverage with our plan will end on October 31. Your new coverage will begin the first day of the next month (November 1, in this example).
How to end your membership in our plan
If you decide to end your membership, tell Healthy Connections Medicaid or Medicare that you want to leave First Choice VIP Care Plus:
- Call South Carolina Healthy Connections Choices at 1-877-552-4642 (TTY 1-877-552-4670), Monday through Friday from 8 a.m. to 6 p.m.
- Call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048), 24 hours a day, seven days a week.
You may choose to enroll in a different Medicare-Medicaid Plan, or choose to get your Medicare and Healthy Connections Medicaid services separately.
Other situations when your membership ends
These are the cases when First Choice VIP Care Plus 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 Healthy Connections Medicaid. Our plan is for people who qualify for both Medicare and Healthy Connections Medicaid.
- If you move out of our service area.
- If you are away from our service area for more than six months.
- If you enter a nursing home or skilled nursing facility outside the plan’s service area and live there for more than six months.
- If you go to jail or prison for a criminal offense.
- If you lie about or withhold information about other insurance you have for prescription drugs.
- If you are not a United States citizen or are not lawfully present in the United States.
- 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 Member ID Card to get medical care.
Rules against asking you to leave our plan for any health-related reason
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 1-877-486-2048), 24 hours a day, seven days a week. You should also call the Healthy Connections Prime Advocate at 1-844-477-4632 (TTY 711).
Your 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. You may file a grievance or make a complaint about our decision to end your membership. For more information on how to file a grievance , you may also see Chapter 9, Section 10 of the Member Handbook (PDF) or call Member Services at 1-888-978-0862 (TTY 711), 7 days a week, 8 a.m. to 8 p.m.
How to 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 or see Chapter 10 of the Member Handbook (PDF).