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 disenrollment form, linked below, for the full list of exceptions.

Medicare Advantage Disenrollment Form

Disenroll from the enhanced dental and vision package^*

You may disenroll from the optional enhanced dental and vision 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 Dental and Vision package does not disenroll you from your Priority Health Medicare Advantage plan. You will continue to have preventive vision and dental coverage included as part of your Medicare Advantage plan. Refer to your Evidence of Coverage document for details.

Enhanced Dental and Vision package disenrollment Form

Please note, you will need to sign your name (not electronically) and send it in to us at Priority Health, MS 1175, 1231 E. Beltline, Grand Rapids, MI 49525 or scan and email it to PH-MedicareEnrollment@spectrumhealth.org.

If you have any questions contact Customer Service at 888.389.6648, seven days a week, 8 a.m. – 8 p.m. (TTY users call 711). 

^*Does not apply to PriorityMedicare D-SNP plan.