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Your Rights upon Disenrollment


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Chapter 10 of your Evidence of Coverage includes information on the member’s and plan’s rights and responsibilities upon disenrollment. Visit the Plan Materials and Forms page to view your plan’s Evidence of Coverage.

Health Net's Responsibilities
Upon your (member) disenrollment from the plan, Health Net must:

  • Provide you with an acknowledgement and confirmation of disenrollment notice.
  • Provide you with a denial of or rejection by CMS of disenrollment, if applicable.
  • Inform you about Medigap rights during a special enrollment period.
  • Provide advance notice in the event you are involuntarily disenrolled and explain reasons for disenrollment.
  • Provide advance notice in the event your enrollment in a Group Medicare Advantage plan is ending.

Member Responsibilities

  • You must make a written request for disenrollment prior to the 1st of the month in which disenrollment is intended.
  • You can only disenroll during qualifying election periods such as the Annual Election Period (October 15 - December 7), or if you qualify for a Special Election period (SEP). The Medicare Advantage Disenrollment Period (MADP), from January 1 to February 14th allows you to return to Original Medicare. You would then be eligible for a SEP and may request enrollment in a PDP.

Member Notifications

  • You will be advised that upon disenrollment from Medicare Advantage with a Part D plan, that unless you obtain another Part D plan, or otherwise elect another type of creditable prescription drug coverage, that you may be subject to a Late Enrollment Penalty should a lapse in coverage occur for 63 or more days.
  • You will be reminded that if you do not enroll in another Medicare Advantage Plan or Medicare Advantage Plan with Prescription Drug coverage, that you will be enrolled in Original Medicare.