There are only certain times during the year when you may voluntarily end your membership with us. The key time to make changes is the Medicare Fall open enrollment period (also known as the "Annual Enrollment Period"), which occurs every year from October 15 - December 7. This is the time to review your health care and drug coverage for the following year and make changes to your Medicare health or prescription drug coverage. Any changes you make during this time will be effective January 1. Certain individuals, such as those with Medicaid, those who get extra help or who move, may make changes at other times. For more information on other times during the year you may be eligible to voluntarily end your membership, please call our Customer Care at 1-800-671-6081 (TTY: 711), 8 a.m. - 8 p.m., Monday - Friday. From October 1 - March 31, representatives are also available weekends from 8 a.m. - 8 p.m.
If you wish to leave Excellus BlueCross BlueShield and you are not enrolling in another Medicare Prescription Drug Plan, you will need to submit a disenrollment request. You may send your request in writing to us at: PO Box 546, Buffalo, NY 14201-0546. Or, you may send your request to our fax number at (716-847-1257). Please be sure to sign and date your letter.
To obtain a copy of a disenrollment form, please call our Customer Care at 1-800-671-6081 (TTY: 711), 8 a.m. - 8 p.m., Monday - Friday. From October 1 - March 31, representatives are also available weekends from 8 a.m. - 8 p.m.
Important: If you disenroll from a Medicare prescription drug plan and go without creditable prescription drug coverage (coverage that is at least as good as Medicare drug coverage), you may have to pay a penalty if you join later.
Excellus BlueCross BlueShield may disenroll you for the following reasons:
If we end your membership in our Plan we will tell you our reasons in writing and explain how you may file a complaint against us if you want to.
No member of any Medicare Prescription Drug Plan may be asked to leave the Plan for any health-related reasons or the number of prescriptions a member takes. If you ever feel that you are being encouraged or asked to leave Excellus BlueCross BlueShield because of your health, you should call 1-800-MEDICARE (1-800-633-4227); TTY: 711 - the national Medicare help line.
If Excellus BlueCross BlueShield leaves the Medicare program or no longer offers prescription drug coverage in the service area where you live, we will notify you in writing. If this happens, your membership in Excellus BlueCross BlueShield will end, and you will have to enroll in another Medicare Prescription Drug Plan to continue your prescription drug coverage.
Your choices include joining another Medicare Prescription Drug Plan or a Medicare Advantage Plan with prescription drug coverage if these plans are available in your area and are accepting new members. Once we have notified you in writing that we are leaving the Medicare program or the area where you live, you may enroll in another plan.
Excellus BlueCross BlueShield has a contract with the Centers for Medicare & Medicaid Services (CMS), the government agency that runs Medicare. This contract may be renewed each year. However, Excellus BlueCross BlueShield or CMS can decide to end the contract at any time. You will generally be notified 90 days in advance if this situation occurs. However, your advance notice may be as little as 30 days or even fewer days if CMS must end our contract in the middle of the year.
Excellus BlueCross BlueShield's contract with the Centers for Medicare & Medicaid Services (CMS) is reviewed annually, and the availability of coverage beyond the end of the current contract year is not guaranteed.
Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Y0028_9775_C.
This page last updated 10-01-2023.