How to Disenroll from a SilverScript Medicare Part D Plan
Can I disenroll from a SilverScript PDP plan?
As a Medicare beneficiary and SilverScript plan member, you have the right to request disenrollment from your
Medicare Part D prescription drug plan. When you voluntarily choose to disenroll from your plan, and your
request is approved, you are choosing to discontinue your Medicare prescription drug coverage, and your
plan will no longer cover any prescription drugs you receive. Your disenrollment must be approved by the
Centers of Medicare and Medicaid Services.
Do I have to disenroll from my current Part D plan to enroll in a different plan?
No. You can switch to a new Medicare drug plan simply by joining another prescription drug plan during the
Annual Enrollment Period (AEP) or during a Special Enrollment Period (SEP) if you qualify. You don’t need
to cancel or disenroll from your old Medicare drug plan, as your old coverage will end when your new
prescription drug plan begins.
What if I want to disenroll from my current Medicare Part D
prescription drug plan, but don’t want to enroll in another plan?
If you disenroll from a Medicare Part D prescription drug plan and wait to join another Medicare prescription
drug plan at a later time—and do not have creditable coverage (coverage as good as Medicare coverage)—a Late
Enrollment Penalty (LEP) may apply. To learn more about Medicare’s Late Enrollment Penalty,
call Medicare at 1-800-MEDICARE (Phone Number1-800-633-4227).
TTY users call Phone Number1-877-486-2048, 24 hours a day,
7 days a week.
How do I disenroll from my SilverScript prescription drug plan?
There are four ways to voluntarily disenroll from a SilverScript Medicare Part D prescription drug plan:
Call 1-800-MEDICARE (Phone Number1-800-633-4227):
TTY users call Phone Number1-877-486-2048, 24 hours a day, 7 days a week.
Enroll in another Medicare plan while you’re still enrolled in a SilverScript plan:
If you are already enrolled in a Medicare prescription drug plan such as a SilverScript plan, you will effectively
be disenrolled if you enroll in another Medicare prescription drug plan or Medicare Advantage plan that includes a
prescription drug benefit during the Annual Enrollment Period (AEP) or a Special Enrollment Period (SEP).
You can submit a letter with the required information or you can download and fill out the SilverScript Choice (PDP) Disenrollment Form or SilverScript Plus (PDP) Disenrollment Form. Complete, sign and mail the forms to:
SilverScript Insurance Company
P.O. Box 52425
Phoenix, AZ 85072-2425
Call SilverScript and request a disenrollment form:
Call Customer Care toll-free at Phone Number1-866-235-5660, 24 hours a day, 7 days a week, TTY users call TeleType Number 711,
to inform us of your intention to disenroll and the representative will send you a form to complete.
To formally disenroll from a SilverScript plan, you will be required to submit your disenrollment form.
After filing your request to disenroll, SilverScript will inform you (in writing) of the date your coverage ends.
While you are waiting for your membership to end, you are still a member of the plan. To use your plan benefit, you must
continue to get your prescription drugs through a SilverScript network pharmacy and abide by all plan rules until you are officially disenrolled.
Note: If you do not receive a letter from us informing you of your disenrollment date, call and ask for the date
your coverage will end. Call Customer Care toll-free at Phone Number1-866-235-5660, 24 hours a day,
7 days a week. TTY users call TeleType Number 711.
Medicare Enrollment Reminder
If you choose to join a Medicare Advantage Plan that offers health care coverage with a prescription drug benefit, you must obtain
your Medicare prescription drug coverage through that Medicare Advantage Plan. If you then decide to enroll
in a stand-alone Medicare prescription drug plan, you will be automatically disenrolled from your Medicare
Advantage Plan and will be returned to Original Medicare (Part A and Part B). Your stand-alone drug plan
enrollment will remain valid.
What if I receive Extra Help from Medicare?
If you receive Extra Help from Medicare, you may disenroll from your Medicare Part D prescription drug plan
and enroll in another Medicare prescription drug plan once per month.
Can I be involuntarily disenrolled from my SilverScript plan?
Although SilverScript will never disenroll you or ask you to disenroll from our plan due to health-related
reasons, there are certain circumstances that will result in your involuntary disenrollment from a
SilverScript plan, some of these include:
- You do not stay continuously enrolled in Medicare Part A or B (or both).
- You move out of the service area or are away from the plan’s service area for more than 12 months. (Note: If you plan to move or take a long trip,
we encourage you to call Customer Care and ask if the place you are moving or traveling to is in the
SilverScript plan service area.)
- You knowingly falsify or withhold information about other parties that provide reimbursement for your
prescription drug coverage.
- You continuously behave in a way that is disruptive and makes it difficult for us to provide care for you
and other members of our plan. (We cannot make you leave our plan for this reason unless we get
permission from Medicare first.)
- You do not pay your plan’s monthly premiums; you may be notified in writing that you have a grace period
during which you can pay the plan premiums before your membership ends.
- Medicare terminates its contract with SilverScript, or SilverScript terminates its contract with Medicare or no longer offers prescription drug coverage.
If you are involuntarily disenrolled from your SilverScript plan, you have the right to ask us to reconsider this decision by contacting Customer Care.
If you have any questions about disenrolling from our plan, please call SilverScript Customer Care toll-free at Phone Number1-866-235-5660, 24 hours a day, 7 days a week. TTY users call TeleType Number