Disenroll from Medicare Advantage

Typically, you may disenroll from a Medicare Advantage plan only during the annual enrollment period from October 15 through December 7 each year, or during the Medicare Advantage Open Enrollment Period from January 1 through March 31 of each year.

There are exceptions that may allow you to disenroll outside of this period. For example, if you receive help paying for your monthly premiums or drug costs, you may be able to disenroll outside of these times.

See the full list of exceptions and additional details on the disenrollment form.

Medicare Advantage Disenrollment form

Disenroll from the Vision, Dental and Hearing package

You may disenroll from the optional Vision, Dental and Hearing package anytime throughout the year. You will be disenrolled effective on the first of the month after Priority Health Medicare receives your signed and completed disenrollment form.

Disenrolling in the Priority Health Optional Enhanced Vision, Dental and Hearing Package does not disenroll you from your Priority Health Medicare Advantage plan. If you have any questions contact Customer Service at 888.389.6648, 7 days a week, 8 a.m. – 8 p.m. (TTY users call 711).

If you are a PriorityMedicare Value, PriorityMedicare Merit, PriorityMedicare, or PriorityMedicare Select member you will continue to have preventive dental coverage included as part of your Medicare Advantage plan. Refer to your Evidence of Coverage document for details.

Vision, Dental and Hearing package disenrollment form