Rights and Responsibilities

There are only certain times during the year when you may voluntarily end your membership in our Plan. The key time to make changes is the Medicare fall open enrollment period (also known as the "Annual Election Period"), which occurs from October 15 - December 7. This is the time to review your health care and drug coverage for the following year and make changes to your Medicare health or prescription drug coverage. Any changes you make during this time will be effective January 1. Certain individuals, such as those with Medicaid, those who get extra help or who move, may make changes at other times. For more information on other times during the year you may be eligible to voluntarily end your membership, please call Customer Care toll-free at 1-877-883-9577 (TTY 711) 8 a.m. to 8 p.m., Monday – Friday. From Oct. 1 to Mar. 31, representatives will be available seven days a week from 8 a.m. to 8 p.m.

If you wish to leave Simply Prescriptions and you are not enrolling in another Medicare Prescription Drug Plan, you will need to submit a disenrollment request. You may send your request in writing to us at: PO Box 211316, Eagan, MN 55121-0146. Or, you may send your request to our fax number at 716-857-6160. Please be sure to sign and date your letter.

To obtain a copy of a disenrollment form, please call Customer Care toll-free at 1-877-883-9577 (TTY 711) 8 a.m. to 8 p.m., Monday – Friday. From Oct. 1 to Mar. 31, representatives will be available seven days a week from 8 a.m. to 8 p.m..

During the fall open enrollment period, if you want to end your membership in our plan this is what you need to do:

  • If you are planning on joining another Medicare Prescription drug plan: Simply join the new Medicare Prescription drug plan. You will be disenrolled automatically from our plan when your new coverage begins on January 1.
  • If you are planning on enrolling in a Medicare Advantage plan: Request enrollment in the new plan. In most cases, you will be disenrolled automatically when your new plan's coverage begins on January 1.

Exception: If you are joining a Medicare Advantage Private Fee-for-Service plan and that plan does not offer drug coverage, or a Medicare Medical Savings Account (MSA) Plan, enrollment will not automatically disenroll you from our plan. Therefore, you will need to do the following:

  • To join a new Medicare prescription drug plan,
    • Simply join the new Medicare prescription drug plan, or
    • If you do not want Medicare prescription drug coverage, find out how to request disenrollment from our plan by calling Customer Care toll-free at 1-877-883-9577 (TTY 711) 8 a.m. to 8 p.m., Monday – Friday. From Oct. 1 to Mar. 31, representatives will be available seven days a week from 8 a.m. to 8 p.m. You may also call 1-800-MEDICARE (1-800-633-4227) (TTY 711) to request disenrollment from our plan. Your enrollment in Original Medicare will be effective January 1.
  • If you would like to end your membership without joining any other Medicare health or prescription drug plan: Contact our Customer Care department to find out how to request disenrollment. You may also call 1-800-MEDICARE (1-800-633-4227) (TTY 711) (24 hours a day, 7 days a week) to request disenrollment from our plan. Your enrollment in Original Medicare will be effective January 1.

Important: If you disenroll from a Medicare prescription drug plan and go without creditable prescription drug coverage (coverage that is at least as good as Medicare drug coverage), you may have to pay a penalty if you join later.

Simply Prescriptions may disenroll you for the following reasons:

  • You do not stay continuously enrolled in Medicare Part A or Part B (or both)
  • If Simply Prescriptions is no longer contracting with Medicare or leaves your service area
  • If you move out of the Simply Prescriptions service area or are away from the service area for more than 6 months
  • You materially misrepresent third-party reimbursement
  • You fail to pay your Plan premium
  • You engage in disruptive behavior, provided fraudulent information when you enrolled or abuse your enrollment card
  • If you let someone else use your Plan membership card to get medical care

If we end your membership in our Plan we will tell you our reasons in writing and explain how you may file a complaint against us if you want to.

We cannot ask you to leave the plan because of your health.
No member of any Medicare Prescription Drug Plan may be asked to leave the Plan for any health-related reasons or the number of prescriptions a member takes. If you ever feel that you are being encouraged or asked to leave Simply Prescriptions because of your health, you should call 1-800-MEDICARE (1-800-633-4227)(24 hours a day, 7 days a week); TTY/TDD 1-877-486-2048 - the national Medicare help line.

A plan may not be available to you the following year because by law, plan sponsors can choose not to renew their contract with CMS or reduce their service area and CMS may also refuse to renew the contract, thus resulting in a termination or non-renewal.

Simply Prescriptions contracts with the Federal Government and is a PDP plan with a Medicare contract. Enrollment in Simply Prescriptions depends on contract renewal. Submit feedback about your Medicare prescription drug plan at www.Medicare.gov or by contacting the Medicare Ombudsman. _.

This page last updated 10-01-2026.

 

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