Don't Want the Plan?

If you are Medicare-eligible and do not want the Medicare Advantage Plan

You have the option not to enroll in the Medicare Advantage Plan. If you do not want to be enrolled in this plan, you must return a completed Enroll/Change/Cancel form to MCHCP indicating you want to cancel your coverage. If you do not return the form, you will be automatically enrolled in the Medicare Advantage Plan. Please review your options carefully before choosing to cancel your enrollment. If you decide not to enroll in the Medicare Advantage Plan:

• You will lose your medical and prescription drug coverage through MCHCP, and you and your dependents will not be able to enroll at a later time.
• If your Medicare-covered dependent decides not to enroll, s/he will lose medical and prescription drug coverage through MCHCP, and will not be able to enroll at a later time.
• If you are a long-term disability subscriber, you will lose your medical and prescription drug coverage through MCHCP, and you will not be able to enroll until your retirement date.