Potential for Contract Termination
Health Net Cal MediConnect Plan must end your membership in the plan if any of the following happen:
- If you do not stay continuously enrolled in Medicare Part A and Part B.
- If you move out of our service area for more than six months.
- If you become incarcerated.
- If you lie about or withhold information about other insurance you have that provides prescription drug coverage.
- If you intentionally give us incorrect information when you are enrolling in our plan and that information affects your eligibility for our plan.
- If 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 cannot make you leave our plan for this reason unless we get permission from Medicare first.
- If you let someone else use your membership card to get medical care.
- If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General.
- If you no longer qualify for Medi-Cal. Our plan is for people who qualify for both Medicare and Medi-Cal. If you no longer qualify for Medi-Cal or your circumstances have changed so that you are no longer eligible for Cal MediConnect, you may continue to get your benefits from Health Net Cal MediConnect for an additional one-month period. This additional time will allow you to correct your eligibility information if you believe that you are still eligible. You will receive a letter from us about the change in your eligibility with instructions to correct your eligibility information.
- To stay a member of Health Net Cal MediConnect, you must qualify again within the one-month period.
- If you don't qualify by the end of the one-month period, you'll be disenrolled from Health Net Cal MediConnect.