Medicare Resources

• If you do not stay continuously enrolled in Medicare Part A and Part B.
• If you are no longer eligible for Medicaid.  (This applies to all HMO Special Needs  Plans (SNP).
• If you become incarcerated (go to prison).
• If you lie about or withhold information about other insurance you have that provides prescription drug coverage.
• If you intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan (we cannot make you leave our plan for this reason unless we get permission from Medicare first).
• If you continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan.
• If you let someone else use your membership card to get medical care (if we end your membership because of this reason, Medicare may have your case investigated by the Inspector General).
• If you enroll into another plan, Medicare will notify us and we will update your records and send you confirmation of your disenrollment.
• If you move out of our service area for more than 6 months.

During the Annual Enrollment Period that runs from October 15th through December 7th each year: 

• You may disenroll from Healthfirst NJ Medicare Plan and return to Original Medicare or you may enroll in another Medicare Advantage Plan or Prescription Drug Plan and be disenrolled from our plan.  
• We will send you confirmation of your disenrollment that will be effective January 1 of the following year.  
• If you did not intend to disenroll from our plan, you will need to contact us to cancel your disenrollment before the last day of the month when you are scheduled to be disenrolled.
  

During the Medicare Advantage Annual Disenrollment Period that runs from January 1st through February 14th each year: 

• You may disenroll from our plan and return to Original Medicare.  You have until February 14 to join a separate Medicare prescription drug plan for your drug coverage.

• Your membership will usually end on the first day of the month after we receive your request to change your plan.  You may choose to enroll in a Medicare prescription drug plan and your membership in the drug plan will begin the first day of the month after the drug plan gets your enrollment request.

If you are eligible for both Medicare and Medicaid (dual-eligible) and have medical assistance from the State or receive Extra Help for Part D drugs from Medicare: 

• You may disenroll at any time.  Your disenrollment will be effective the first day of the month after we get your disenrollment request.
• You may choose to disenroll by contacting Healthfirst NJ Medicare Plan in writing.  Be sure to sign and date your disenrollment request.  
• You may also switch to another Medicare Advantage Plan, or return to Original Medicare with a standalone Medicare prescription drug plan (if you return to Original Medicare and do not enroll in a separate Medicare prescription drug plan, Medicare may enroll you in a drug plan, unless you have opted out of automatic enrollment).

If you qualify for other Special Enrollment Periods: 

• You will automatically be disenrolled from our plan.   Special Enrollment Periods vary depending on your situation.
• If you are eligible for a Special Enrollment Period, you can choose to change both your Medicare health coverage and prescription drug coverage. Your membership will usually end on the first day of the month after we receive your request to change your plan.