Your benefits from AllCARE for Seniors can be stopped if you choose to give up your enrollment in the program. If you decide to give up these benefits, you have done it voluntarily or on your own. If you no longer meet the conditions of enrollment, you will give up the benefits involuntarily.
You must still use AllCARE for Seniors services and pay the monthly charge (if there is any) until your time of being a Participant is over. At least thirty (30) days written notice is needed to get you back into the Medicare and/or Medicaid program.
NOTE: You cannot disenroll from AllCARE for Seniors by going to the Social Security office. You must tell AllCARE for Seniors you want to leave the program.
Voluntarily Leaving AllCARE for Seniors - If you want to cancel your benefits by leaving AllCARE for Seniors, you should talk about it with a Team member at the AllCARE for Seniors Center. You may leave for any reason at any time. However, please let us know either verbally or in writing. If you tell us verbally of your wish to disenroll, you must sign a disenrollment form. AllCARE for Seniors will disenroll you as soon as possible, but AllCARE for Seniors needs time to coordinate your health care outside of AllCARE for Seniors with community providers so that your health needs may continue to be met.
Involuntarily Leaving AllCARE for Seniors - AllCARE for Seniors can stop your benefits by giving you thirty (30) days notice in writing if:
- You move or are out of the service area for more than 30 consecutive days unless AllCARE for Seniors agrees to a longer absence due to extenuating circumstances.
- You or your family or caregiver engages in disruptive or threatening behavior that jeopardizes your own health or safety, or the health or safety of others.
- You or your family or caregiver consistently refuses to comply with your plan of care or the terms of the AllCARE for Seniors enrollment agreement.
- AllCARE for Seniors agreement with CMS and Virginia Department of Medical Assistance Services is not renewed or is terminated.
- AllCARE for Seniors is unable to offer healthcare services due to the loss of state licenses or contracts with outside providers.
- You no longer meet nursing facility level of care eligibility and are not deemed eligible.
- You fail to pay or make satisfactory arrangements to pay any amount due AllCARE for Seniors after a 30-day grace period.
NOTE: An involuntary disenrollment decision is not taken lightly. AllCARE for Seniors is committed to providing services to you and will exhaust all possible options to remedy a situation before proceeding with an involuntary disenrollment.
The effective date to all rights to benefits will stop at the date coordinated between Medicare and Medicaid, depending on participant eligibility. You must use AllCARE for Seniors services until that date.
Whether your disenrollment is voluntary or involuntary, AllCARE for Seniors will do its best to make sure you receive care in other Medicare and Medicaid programs for which you are eligible. We will work with the Medicare and Medicaid agencies by making your medical records available to your new care providers in a timely manner. We will also work with our community partners to arrange a smooth transition of your care.