Rights and Responsibilities Upon Disenrollment

When can you disenroll?

If you wish to disenroll from EMI Health's Prescription Drug Plan and you are not enrolling in another Prescription Drug Plan, you will need to submit a disenrollment request. You can send your request in writing to us at 5101 S Commerce Street, Murray, Utah 84107-4709; or you can send your request to our fax number at 801-269-9734. Please be sure to sign and date your letter. To obtain a disenrollment form, please call customer service at 1-800-662-5851 (Monday through Friday 8 a.m. to 5 p.m.). TTY users should call 711-1-800-662-5851.

If you are disenrolling to join another Prescription Drug Plan, you must contact that Plan to request enrollment information. Once you are enrolled in your new Plan, your membership in our Plan will be automatically terminated without any action on your part. Your new Plan will tell you the date when your prescription drug coverage in that Plan begins. Your prescription drug coverage with EMI Health will end on that same day (this will be your disenrollment date). Remember, you are still a member of EMI Health's Prescription Drug Plan until your disenrollment date and must continue to get your prescription drug coverage, as usual, through EMI Health until the date your membership ends.

The times when you may switch Part D Plans may vary. Please call our customer service at 1-800-662-5851 (Monday through Friday 8 a.m. to 5 p.m.) if you have questions on the enrollment periods that are available to you. TTY users should call 711-1-800-662-5851.

When can EMI Health disenroll you?

EMI Health's Prescription Drug Plan can disenroll you for the following reasons:

  • You are no longer eligible for Medicare prescription drug coverage.
  • EMI Health is no longer contracting with Medicare or we leave your service area.
  • When you move out of our service area.
  • You materially misrepresent third-party reimbursement.
  • You fail to pay your Plan premium.
  • You provide fraudulent information when you enroll or abuse your enrollment card.

EMI Health cannot ask you to leave the Plan because of your health. No member of any Medicare Prescription Drug Plan can be asked to leave the Plan for any health-related reasons or for the number of prescriptions a member takes. You should call 1-800-MEDICARE (1-800-633-4227; TTY/TDD 1-877-486-2048), the national Medicare help line, if you feel that you have been encouraged to leave EMI Health Prescription Drug Plan for health reasons.