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Disenrollment

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Voluntary Disenrollment

 If you wish to disenroll, you should contact the Mercy LIFE of Alabama Social Worker.  You can disenroll from the program at any time.  Mercy LIFE of Alabama requests that you sign a Disenrollment Form prior to the date of your disenrollment.  This form will indicate that you “will no longer be entitled to service through Mercy LIFE of Alabama after midnight of the last day of the month.” All disenrollments are effective at 12:01 A.M. on the 1st of the month. 

Involuntary Disenrollment

 Mercy LIFE of Alabama wants to keep you as a member and will work with you to resolve problems. If we are no longer able to provide appropriate care, Mercy LIFE of Alabama can terminate your membership by giving you at least 30-day notice in writing. All involuntary disenrollments must be approved by the Alabama Medicaid Agency. 

Disenrollment Process/Rights and Responsibilities of the Participant

The PACE organization must take the following actions upon voluntary or involuntary disenrollment or death of a participant: 

  • Complete the disenrollment as expediently as allowed under Medicare and Medicaid. 
  • Coordinate the disenrollment date between Medicare and Medicaid as applicable. 
  • Will give the Participant 30 days-notice about Disenrollment. 
  • Submit the disenrollment transaction to CMS systems in a timely and accurate manner. 

The PACE organization must continue to provide all needed services, and the PACE participant must continue to use the PACE organization’s services and pay any premiums, until the date the enrollment is actually terminated. The disenrollment date will be coordinated between Medicare and Medicaid for a participant who is dually eligible. No disenrollment will become effective until the participant is appropriately reinstated into other Medicare and Medicaid programs and alternative services are arranged.

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Information Last Updated: Tuesday July 2nd, 2019 14:24:00

H4074_MLOA_Website_CMSAPPROVED_06/12/2019

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