Leave or cancel my prescription drug-only plan (PDP)

Can I disenroll from my PDP plan?

As a Medicare beneficiary and a plan member, you have the right to request disenrollment from your Medicare Part D prescription drug plan. When you voluntarily choose to disenroll from your plan, and your request is approved, you are choosing to discontinue your Medicare prescription drug coverage, and your plan will no longer cover any prescription drugs you receive. Your disenrollment must be approved by the Centers for Medicare & Medicaid Services (CMS).

Do I have to disenroll from my current Part D plan to enroll in a different plan?

No. You can switch to a new Medicare drug plan simply by joining another prescription drug plan during the Annual Enrollment Period (AEP) or during a Special Enrollment Period (SEP) if you qualify. You don’t need to cancel or disenroll from your old Medicare drug plan, as your old coverage will end when your new prescription drug plan begins.

What if I want to disenroll from my current Medicare Part D prescription drug plan, but don’t want to enroll in another plan?

If you disenroll from a Medicare Part D prescription drug plan and wait to join another Medicare prescription drug plan at a later time — and do not have creditable coverage (coverage as good as Medicare coverage) — a Part D Late Enrollment Penalty (LEP) may apply. To learn more about the Medicare Part D Late Enrollment Penalty, call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048, 24 hours a day, 7 days a week.

How do I disenroll from my prescription drug plan (PDP)?

There are four ways to voluntarily disenroll from a Medicare Part D prescription drug-only plan:

1. Enroll in another Medicare plan while I’m still enrolled in a prescription drug-only plan:

If you are already enrolled in a Medicare prescription drug plan (PDP), you will be disenrolled if you enroll in another Medicare prescription drug plan (PDP) or Medicare Advantage plan that includes a prescription drug coverage (MAPD). You can choose another plan during the Annual Enrollment Period (October 15 through December 7 annually) or during a Special Enrollment Period (SEP) allowed by Medicare.

2. By mail or fax:

You can send us a letter with your plan information, or you can download and complete your plan’s form:

SilverScript^® (PDP) Disenrollment Form

SilverScript^® (PDP) Disenrollment Form – Español

Complete, sign and mail or fax the form to:

SilverScript^® Insurance Company
P.O. Box 30007
Pittsburgh, PA 15222-0330
Fax: 1-866-552-6205

3. Call the Member Services number on your member ID card and request a disenrollment form

You can call us 24 hours a day, 7 days a week, to let us know of your intention to disenroll. The representative will send you a form you’ll need to complete. We can’t disenroll you without this form. Once we receive your completed form, we’ll send you a letter informing you of the date your coverage ends.

4. Call Medicare and tell them you want to disenroll

You can call Medicare directly at 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY users, please call 1-877-486-2048. The representative will work with you to process your disenrollment.

While you’re waiting for your enrollment to end, you’re still a member of our plan. To use your prescription drug benefits, you must continue to use one of our network pharmacies and follow the plan rules until you’re officially disenrolled.

Note: If you do not receive a letter from us informing you of your disenrollment date, call the Member Services number on your member ID card. The representative can tell you the date your coverage will end.

Medicare enrollment reminder

If you choose to join a Medicare Advantage plan that offers health care coverage with a prescription drug benefit, you must obtain your Medicare prescription drug coverage through that Medicare Advantage plan. If you then decide to enroll in a stand-alone Medicare prescription drug plan, you will be automatically disenrolled from your Medicare Advantage plan and will be returned to Original Medicare (Part A and Part B). Your stand-alone drug plan enrollment will remain valid.

What if I receive Extra Help from Medicare?

If you receive Extra Help from Medicare, you may disenroll from your Medicare Part D prescription drug plan and enroll in another Medicare prescription drug plan once per quarter during the first nine months of the year.

Can I be involuntarily disenrolled from my prescription drug plan?

Although we will never disenroll you or ask you to disenroll from our plan due to health-related reasons, there are certain circumstances that will result in your involuntary disenrollment. Some of these include:

• You do not stay continuously enrolled in Medicare Part A or B (or both).
• You move out of the service area or are away from the plan’s service area for more than 12 months. (Note: If you plan to move or take a long trip, we encourage you to call Customer Care and ask if the place you are moving or traveling to is in your plan’s service area.)
• You knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drug coverage.
• You continuously behave in a way that is disruptive and makes it difficult for us to provide care for you and other members of our plan. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.)
• You do not pay your plan’s monthly premiums; you may be notified in writing that you have a grace period during which you can pay the plan premiums before your membership ends.
• Medicare terminates its contract with us, or we terminate our contract with Medicare or no longer offers prescription drug coverage.

If you are involuntarily disenrolled from your plan, you have the right to ask us to reconsider this decision by contacting Customer Care. If you have any questions about disenrolling from our plan, please call Customer Care toll-free at 1-866-235-5660, 24 hours a day, 7 days a week. TTY users call 711.