How to Disenroll
If you request disenrollment, you must continue to get all medical care from Meridian Advantage Plan of Michigan until the effective date of disenrollment. Contact us at the phone number below to verify your disenrollment before you seek medical services outside of the Meridian Advantage Plan of Michigan network. We will notify you of your effective date after we get this form from you. If you enroll in another Medicare Advantage or Medicare Prescription Drug Plan, Medicare will cancel your current membership in Meridian Advantage Plan of Michigan on the effective date of your new enrollment. You may not be able to enroll in another plan at that time. Also, if you disenroll from your Medicare prescription drug coverage and want Medicare prescription drug coverage in the future, you may have to pay a higher premium for that coverage.
To disenroll from Meridian Advantage Plan of Michigan or for more information about your rights and responsibilities upon disenrollment, please contact Member Services at 877-902-6784 (TTY users should call 711), Monday - Sunday from 8 a.m. to 8 p.m.
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