How to Disenroll in a Medicaid HMO in Florida
If you need to leave your Florida Medicaid HMO plan, timing is everything. While disenrolling in a plan because you no longer need Medicaid benefits is straightforward, disenrolling in one Medicaid HMO to enroll in a different Medicaid HMO is a little trickier. Outside of an initial 90-day open enrollment period, you must have a state approved "good cause" to switch plans before you plan is up for its yearly review and renewal.
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Instructions
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Understand the rules. After you choose a Medicaid HMO, there is a 90-day period known as open enrollment during which you can change your plan freely. The period after the open enrollment expires is known as the "lock in" time. When you are in the lock in period of your plan, the state must approve your plan change. Approval is granted if you have a good cause to need a different plan. Many reasons meet the good cause criteria, including if your doctor leaves the HMO network, you are receiving substandard care, your doctor doesn't supply translation services that you need, or you need care not covered by your current HMO.
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Contact the Florida Medicaid Enrollment/Disenrollment hotline at 888-367-6554. You will need your Medicaid ID or Gold Card number, the last four digits of your Social Security number and your birth date handy so the caseworker can access your account information.
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Seek disenrollment. If you are leaving Medicaid or are in your open enrollment period, disenrollment is straightforward. If you are in your lock in period, the caseworker will help you determine if you have a good cause reason to disenroll in your current plan to move to a different plan. Note that you may be required to submit evidence to support your claims.
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Tips & Warnings
If you need help selecting a more appropriate Medicaid HMO, contact the Choice Counseling helpline on 866-454-3959.
References
- Photo Credit relaxed doctor image by Keith Frith from Fotolia.com
