Disenroll from Medicare Advantage

You can disenroll from your current Medicare Advantage plan (Part C) and go back to Original Medicare (Part A and B) during the Medicare Advantage disenrollment period, which is from Jan. 1 – Feb. 15. During this period, you also have the option of adding prescription drug coverage.

Use this form to disenroll from our Medicare Advantage plan.

Medicare Advantage Disenrollment form