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Medicare Advantage rights and responsibilities for disenrollment

This information explains your rights and responsibilities if you choose to disenroll from your Medicare Advantage plan. You will not be disenrolled from Security Health Plan until your disenrollment is processed and approved by the Centers for Medicare and Medicaid Services.

You will continue to obtain your health care from a Medicare Advantage plan until your disenrollment date. Neither Security Health Plan nor Medicare will pay for any medical services provided by a physician or hospital, with the exception of urgently needed care, care for a medical emergency, out-of-area renal (kidney) dialysis services, or care that has been approved by us, until your proposed disenrollment date is confirmed.

For a detailed description, please refer to  your   Evidence of Coverage.

Your rights and responsibilities as a member of our plan upon your disenrollment

You have the right to be treated with dignity, respect and fairness at all times. Security Health Plan must obey laws that protect you from discrimination or unfair treatment. These laws do not allow us to discriminate against you (treat you unfairly) because of your race or color, age, religion, national origin, or any mental or physical disability. If you need help with communication, such as help from a language interpreter, please call Customer Service.

You have the right to the privacy of your medical records and personal health information. There are federal and state laws that protect the privacy of your medical records and personal health information. We protect your personal health information under these laws. Any personal information that you give us when you enroll in a Medicare Advantage plan is protected. We will make sure that unauthorized people do not see or change your records. Generally, we must get written permission from you (or from someone you have given legal power to make decisions for you) before we can give your health information to anyone who is not providing your care or paying for your care. There are exceptions allowed or required by law, such as release of health information to government agencies that are checking on quality of care.

The laws that protect your privacy give you rights related to getting information and controlling how your health information is used. We are required to provide you with a notice that tells about these rights and explains how we protect the privacy of your health information. For example, you have the right to look at your medical records, and to get a copy of the records. You also have the right to ask network providers to make additions or corrections to your medical records (if you ask network providers to do this, they will review your request and determine whether the changes are appropriate). You have the right to know how your health information has been given out and used for non-routine purposes. If you have questions or concerns about privacy of your personal information and medical records, please call Customer Service at the phone number listed below.

For questions or concerns, please contact our Customer Service Department at 1-877-998-0998 (TTY 711). We are open 8 a.m. to 8 p.m., 7 days a week from Oct. 1 through March 31.

Security Health Plan and its agents are not in any way connected with the Medicare program. Security Health Plan of Wisconsin, Inc., is an HMO-POS, MSA and D-SNP plan with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in Security Health Plan depends on contract renewal.

This information is not a complete description of benefits. Call Customer Service at 1-877-998-0998 (TTY 711) for more information.

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Last updated: October 2018