Rights and Responsibilities Upon Disenrollment 

When We Must End Your Membership

By law, CenCal CareConnect cannot remove you from the plan for any reason related to your health status. If you believe your membership is being ended unfairly, you can contact Medicare for help: 

• 1-800-MEDICARE (1-800-633-4227) 

• TTY: 1-877-486-2048 

• Available 24/7 

Membership will end if: 

• You no longer have Medicare Part A and Part B. 
• You lose Medi-Cal eligibility through CenCal Health (in this case, the state will automatically return you to Original Medicare). 
• You are outside our service area (Santa Barbara or San Luis Obispo counties) for more than six consecutive months.  
• You move permanently outside of the service area; you will be disenrolled as of the first of the month following either the date of the move or the date CenCal CareConnect is notified of the move.
• You are incarcerated. 
• You become unlawfully present in the United States. 
• You provide false or incomplete information about other prescription drug coverage you may have. 

Membership may end (with Medicare/Medi-Cal approval) if: 

• You intentionally gave false information when joining the plan that affects your eligibility. 

• Your ongoing behavior disrupts the care of other members and makes it hard for us to provide services. 

• You allow another person to use your CenCal CareConnect member ID card. 

• If your membership ends for these reasons, Medicare may request a review by the Inspector General. 

How to Prevent Disenrollment

• Let Member Services know if you’ll be outside of Santa Barbara or San Luis Obispo counties for longer than three months. 

• Report any address changes right away to your County Human Services Agency. 

• Make sure you complete your Medi-Cal renewal each year. If you need help, contact: 

• • Santa Barbara County Department of Social Services: 1-866-404-4007 

• • San Luis Obispo County Department of Social Services: 1-800-834-3002 

• • Or call CenCal Health Member Services for support. 

Ways to Disenroll from CenCal CareConnect

You can choose to leave CenCal CareConnect (HMO D-SNP) at any time for any reason. If you decide to leave, your membership will stop at the end of the month in which we receive your request. However, it may differ depending on the available election period or on what you requested when you enrolled in the new MA or PDP plan. However, specific timeframes and reasons govern when you can switch to a different Medicare Advantage plan. If you join a standalone Medicare Prescription Drug Plan (PDP), you will be automatically disenrolled from CenCal CareConnect and returned to Original Medicare. You will still receive Medi-Cal benefits through CenCal Health.

There are three ways to disenroll from CenCal CareConnect:

1. Call Member Services 

• Toll-free: 1-877-814-1861
• TTY: CA Relay at 711 
• 7 days a week, 8 a.m. to 8 p.m., PT  

2. Send us a signed request

You may mail a letter to CenCal CareConnect Member Services at the address below:

CenCal CareConnect (HMO D-SNP)
ATTN: Enrollment
4050 Calle Real
Santa Barbara, CA 93110 

If we need more details, we’ll reach out to you directly. 

• CenCal CareConnect Disenrollment Form – English
• CenCal CareConnect Disenrollment Form – Spanish

3. Join a different plan

If you join a different Medicare Advantage plan, you will be automatically disenrolled from CenCal CareConnect. Although you can disenroll from CenCal CareConnect in any month of the year, there are specific timeframes and reasons that govern when you can join a different Medicare Advantage plan. Refer to the Medicare and Your Handbook on Medicare.gov for details.

Care During Your Transition

If you seek care outside of CenCal CareConnect’s network before your disenrollment is effective, you may be responsible for the costs if the provider does not bill CenCal Health. To avoid unexpected bills, call Member Services to confirm your disenrollment date before scheduling services outside our network. 

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