Ending your membership

Ending your membership in NaviCare may be voluntary (your own choice) or involuntary (not your own choice). You can find information about your rights and responsibilities upon disenrollment  in your NaviCare SCO Evidence of Coverage or NaviCare HMO SNP Member Handbook in the chapter called, "Ending your membership in the plan."

  • You might leave our plan because you have decided that you want to leave.
    • NaviCare HMO SNP members may leave or change plans during Medicare’s Annual Enrollment Period (Oct. 15–Dec. 7). You can also make a change for the first of each month, but only to either go back to Original Medicare and enroll in a stand-alone Medicare Prescription Drug Plan, or to enroll in another “Fully Integrated Dual Eligible Special Needs Plan”, like NaviCare.
    • NaviCare SCO members can end membership in the plan at any time, for an effective date of the last day of the month that the request is submitted.
    • The process for voluntarily ending your membership varies depending on what type of new coverage you're choosing.

  • There are also limited situations where you don't choose to leave, but we're required to end your membership in NaviCare SCO or NaviCare HMO SNP. We're not allowed to ask you to leave our plan for any reason related to your health.
    • If you're a member of NaviCare HMO SNP and feel that you're being asked to leave our plan because of a health-related reason, you should call Medicare or MassHealth (Medicaid): 
    • Medicare
      1-800-MEDICARE (1-800-633-4227)
      TTY users should call 1-877-486-2048. You may call 24 hours a day, 7 days a week.
    • MassHealth (Medicaid)
      1-800-841-2900
      TTY users should call 1-800-497-4648.
    • If you're a member of NaviCare SCO and feel that you're being asked to leave our plan because of a health-related reason, you should call MassHealth (Medicaid) at 1-800-841-2900. TTY users should call 1-800-497-4648.

If you leave NaviCare, it may take time before your membership ends and your new coverage goes into effect. During this time, you must continue to get your medical care, prescription drugs, and over-the-counter drugs through our plan.

If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership.

You can find more information about ending your membership in your NaviCare SCO or NaviCare HMO SNP Evidence of Coverage in the chapter called, "Ending your membership in the plan."

We must end your membership in NaviCare HMO SNP if any of the following happen:

  • You no longer have Medicare Part A and Part B.
  • You're no longer eligible for MassHealth Standard (Medicaid). 
  • You move out of our service area.
  • You're away from our service area for more than 6 months.
  • You become incarcerated (go to prison).
  • You're not a United States citizen or lawfully present in the United States.
  • You lie about or withhold information about other insurance you have that provides prescription drug coverage.
  • You intentionally give us incorrect information when you're enrolling in our plan and that information affects your eligibility for our plan. (We can't make you leave our plan for this reason unless we get permission from Medicare first.)
  • You continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan. (We can't make you leave our plan for this reason unless we get permission from Medicare first.)
  • You let someone else use your membership card to get medical care. (We can't make you leave our plan for this reason unless we get permission from Medicare first.)
  • You're required to pay the extra Part D amount because of your income and you don't pay it. Medicare will disenroll you from our plan.
  • You have other comprehensive health insurance (except Medicare).

We must end your membership in NaviCare SCO if any of the following happen:

  • You're no longer eligible for MassHealth Standard (Medicaid).
  • You move out of our service area.
  • You're away from our service area for more than six months.
  • You become incarcerated (go to prison).
  • You're not a United States citizen or lawfully present in the United States.
  • You lie about or withhold information about other insurance you have that provides prescription drug coverage.
  • You intentionally give us incorrect information when you're enrolling in our plan and that information affects your eligibility for our plan.
  • You continuously behave in a way that is disruptive and makes it difficult for us to provide medical care for you and other members of our plan.
  • You let someone else use your membership card to get medical care or prescription drugs.
  • You have other comprehensive health insurance (except Medicare).

H8928_260010_C Approved 10012025
The information on this page was last updated on 10/1/2025.