You will still qualify for both Medicare and Medicaid benefits if you leave our plan. Here are ways you can end your membership in our plan and your health coverage options after leaving our plan.

When can you end your membership in our Medicare-Medicaid plan?

You can end your membership in Virginia Premier CompleteCare (Medicare-Medicaid Plan at any time). Your membership will end on the last day of the month that we get your request to change your plan. For example, if we get your request on January 18, your coverage with our plan will end on January 31. Your new coverage will begin the first day of the next month.
  • For information on Medicare and Medicaid options and services when you leave our plan, see the Member Handbook, located on our Plan Documents page.
These are ways you can get more information about when you can end your membership:
  • Call the Coordinated Care HelpLine at 1-855-889-5243, Monday through Friday, 8:30 am to 6:00 pm. TTY users should call 1-800-817-6608.
  • Call the Virginia Insurance Counseling and Assistance Program (VICAP) at 1-800-552-3402.
  • Call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. TTY users should call 1-877-486-2048.

How do you end your membership in our plan?

If you decide to end your membership, tell Medicaid or Medicare that you want to leave Virginia Premier CompleteCare:
  • Call the Coordinated Care HelpLine at 1-855-889-5243, Monday through Friday, 8:30 am to 6:00 pm. TTY users should call 1-800-817-6608; OR
  • Send Maximus an Enrollment Change Form. You can get the form at www.virginiaccc.com or by calling the Coordinated Care Help Line at 1-855-889-5243 if you need them to mail you one; OR
  • Call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. TTY users (people who are deaf, hard of hearing, or speech disabled) should call 1-877-486-2048. When you call 1-800-MEDICARE, you can also enroll in another Medicare health or drug plan.

How do you join a different Medicare-Medicaid plan?

If you want to keep getting your Medicare and Medicaid benefits together from a single plan, you can join a different Medicare-Medicaid plan. To enroll in a different Medicare-Medicaid plan:
  • Call the Coordinated Care Help Line at 1-855-889-5243, Monday through Friday, 8:30 am to 6:00 pm. TTY users should call 1-800-817-6608. Tell them you want to leave Virginia Premier CompleteCare and join a different Medicare-Medicaid plan. If you are not sure what plan you want to join, they can tell you about other plans in your area; OR
  • Send Maximus an Enrollment Change Form. You can get the form at www.virginiaccc.com, or by calling the Coordinated Care Help Line at 1-855-889-5243 if you need them to mail you one.
Your coverage with Virginia Premier CompleteCare will end on the last day of the month that we get your request.

If you leave our plan and you do not want a different Medicare-Medicaid plan, how do you get Medicare and Medicaid services?

If you do not want to enroll in a different Medicare-Medicaid plan after you leave Virginia Premier CompleteCare, you will go back to getting your Medicare and Medicaid services separately. Please see Chapter 10 of the Member Handbook for more information, located on our Plan Documents page.

If you leave the Medicare-Medicaid plan, you can see any provider that accepts Medicaid.

Until your membership ends, you will keep getting your medical services and drugs through our plan If you leave Virginia Premier CompleteCare, it may take time before your membership ends and your new Medicare and Medicaid coverage begins. During this time, you will keep getting your health care and drugs through our plan. Please see the Member Handbook for more information, located on our Plan Documents page.
  • You should use our network pharmacies to get your prescriptions filled. Usually, your prescription drugs are covered only if they are filled at a network pharmacy, including through our mail-order pharmacy services.
  • If you are hospitalized on the day that your membership ends, your hospital stay will usually be covered by our plan until you are discharged. This will happen even if your new health coverage begins before you are discharged.

Your membership will end in certain situations

These are the cases when Virginia Premier CompleteCare must end your membership in the plan:
  • If there is a break in your Medicare Part A and Part B coverage.
  • If you no longer qualify for Medicaid. Our plan is for people who qualify for both Medicare and Medicaid.
  • If you move out of our service area.
  • If you are away from our service area for more than six months.
  • If you move or take a long trip, you need to call Member Services to find out if the place you are moving or traveling to is in our plan’s service area.
  • If you go to prison.
  • If you lie about or withhold information about other insurance you have for prescription drugs.
We can make you leave our plan for the following reasons only if we get permission from Medicare and Medicaid first:
  • If you intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan.
  • 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 ID card to get medical care.
  • If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.
We cannot ask you to leave our plan for any reason related to your health

If you feel that you are being asked to leave our plan for a health-related reason, you should call Medicare at 1‑800‑MEDICARE (1‑800‑633‑4227). TTY users should call 1‑877‑486‑2048. You may call 24 hours a day, seven days a week. You should also call the Medicaid helpline at 804-786-6145.

The only exception is if you decide to enroll in a hospice program. If you enroll in hospice, we must dis-enroll you from our plan so you can receive those services. You can then see any Medicaid or Medicare provider.

You have the right to make a complaint if we end your membership in our plan

If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership. You can also see Chapter 9 of the Member Handbook, located on our Plan Documents page for information about how to make a complaint.

Where can you get more information about ending your plan membership?

If you have questions or would like more information on when we can end your membership, you can call Member Services at 1-855-338-6467.

Additional Information

Virginia Premier CompleteCare is a health plan that contracts with both Medicare and the Virginia Department of Medical Assistance Services to provide benefits of both programs to enrollees.

You can get this information for free in other languages. Call 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice). The call is free.

You can ask for this information in other formats, such as Braille or large print. Call 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice).

H3067_032814WEB CMS Approved