How to Enroll or Disenroll

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Enrolling in Community Advantage Plus

Enrolling in Community Advantage Plus (HMO D-SNP) is easy!

Call our Member Services representatives at 1-888-484-1412 (TTY: 711). The Member Services representative will take your information and a Marketing Representative will call you to schedule an appointment to complete the enrollment application form.
Community Advantage Plus representatives are available 24 hours a day, 7 days a week, including holidays.
To enroll in Community Advantage Plus you can also call Health Care Options, the State Enrollment Broker at 1-844-580-7272 (TTY 1-800-430-7077). Hours of operation: Monday – Friday, 8am-5pm. https://www.healthcareoptions.dhcs.ca.gov/
If you live in California and you are receiving Medi-Cal and Medicare benefits, you can sign up for Community Advantage Plus at any time. It’s a simple way to combine your Medi-Cal and Medicare benefits into one easy to use health care plan.

No premiums or deductibles.
You pay zero dollars out of pocket for doctor’s visits, emergency services, or hospitalization.

Disenrolling from Community Advantage Plus

Ending your membership in our plan may be voluntary (your own choice) or involuntary (not your own choice; there are limited situations where we are required to end your membership. For example, if you move permanently out of our geographic service area).

If you leave Community Advantage Plus, it may take time before your membership ends and your new Medicare and Medi-Cal coverage begins. See your Member Handbook for more information. During this time, you will continue to receive your health care and medication through our plan.

If we end your membership in Community Advantage Plus, we must tell you our reason(s) in writing for ending your membership. We must also explain how you can file a grievance or make a complaint about our decision to end your membership. Please see the Member Handbook for more information about how to make a complaint.

For full information on Community Advantage Plus benefits, please call our Member Services Department at 1-888-484-1412 (TTY: 711). Community Advantage Plus representatives are available 24 hours a day, 7 days a week, including holidays.

You have the right to leave our Community Advantage Plus plan at certain times during the year. No one can make you stay in our plan if you do not want to. If you leave our plan, you will still be in the Medicare and Medi-Cal programs. You have the right to get most of your health care services through Original Medicare or another D-SNP plan. You can get your Medicare Part D prescription drug benefits from a prescription drug plan or from a D-SNP plan. Your Medi-Cal benefits will continue to be offered through the Community Health Plan of Imperial Valley unless you choose a different plan available in this county.

If you decide to end your membership, tell Medicare or Medi-Cal that you want to leave Community Advantage Plus:

Call Health Care Options at 1-844-580-7272, Monday through Friday, from 8:00 a.m. to 5:00 p.m. TTY users should call 1-800-430-7077; OR
Call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users (people who are deaf, hard of hearing, or speech disabled) should call 1-877-486-2048. When you call 1-800-MEDICARE, you can also enroll in another Medicare health or drug plan.

Please see the Member Handbook for more information on leaving our plan.

If you have questions, please call Community Advantage Plus at 1-888-484-1412 (TTY: 711), 24 hours a day, 7 days a week. The call is free.

How To Change To A Different Plan

If you decide to leave Community Advantage Plus, you can switch to a different plan or to original Medicare (either with or without a separate Medicare prescription drug plan).

If you want to change to a different plan, there are many choices. Medicare Advantage plans and/or Medicare prescription drug plans are available as well as the plan you are now enrolled in. These other plans may differ in coverage, monthly premiums, and cost sharing amounts.

Beneficiaries who are eligible to join the Community Health Plan of Imperial Valley’s Community Advantage Plus plan may enroll or disenroll at certain times of the year.

How do you make a change?

If you want to keep getting your Medicare and Medi-Call benefits together from a single plan, you can join a different D-SNP plan.
To enroll in a different D-SNP plan:

Call Health Care Options at 1-844-580-7272, Monday through Friday, from 8:00 a.m. to 5:00 p.m. TTY users should call 1-800-430-7077; Tell them you want to leave Community Advantage Plus and join a different D-SNP plan. If you are not sure what plan you want to join, they can tell you about other plans in your area.

Your coverage with Community Advantage Plus will end on the first day of the month based on the election period that you qualify for at that time.

If you need information about how to choose or change plans, please refer to your Member Handbook for more information. It will tell you what you need to do. You can also call the Member Services Department at 1-888-484-1412 (TTY: 711) for assistance.

Disclaimers

Community Advantage Plus (HMO D-SNP) is an HMO D-SNP health plan with a Medicare contract and a contract with the Medi-Cal program. Enrollment in Community Advantage Plus depends on contract renewal.

ATTENTION: If you speak another language, language assistance services, free of charge, are available to you. Call 1-888-484-1412 (TTY: 711), 24 hours a day, 7 days a week. The call is free.

ATENCIÓN: Si habla español, hay servicios de asistencia de idiomas disponibles sin cargo. Llame al 1-888-484-1412 (TTY: 711). Las llamadas a estos números son gratuitas.