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Disenrollment Rights

Disenrollment Rights

Ending your membership in Eon Health may be voluntary (your own choice) or involuntary (not your own choice):

You may end your membership in our plan only during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the Annual Medicare Advantage Disenrollment Period.

In certain situations, you may also be eligible to leave the plan at other times of the year.

There are also limited situations where you do not choose to leave, but we are required to end your membership.

If you are leaving our plan, you must continue to get your medical care through our plan until your membership ends.

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Clear Spring Health has a contract with Medicare to offer PPO, HMO, and PDP Plans. Eon Health has a contract with the Georgia Medicaid program and a contract with the South Carolina Medicaid program. Enrollment in these plans depends on contract renewal. Clear Spring Health Deluxe (HMO SNP): This plan is available to anyone who has both Medicare and received assistance from the State. Clear Spring Health Silver (HMO SNP): This plan is available to anyone with Medicare who has been diagnosed with Cardiovascular Disorder, Chronic Heart Failure or Diabetes. Eon Health has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2022 based on a review of Eon Health’s Model of Care. This information is not a complete description of benefits. Contact the plan for more information. Limitations, Copayments, and restrictions may apply. Benefits, formulary, pharmacy/provider network, premium and cost sharing may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Premiums, co-pays/co-insurance may vary based on the level of Extra Help you receive. Please contact the plan for further details. Medicare beneficiaries may also enroll in Eon Health through the CMS Medicare Online Enrollment Center located at www.medicare.gov. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary. Clear Spring Health Choice (PPO): Out of network/non-contracted providers are under no obligation to treat Eon Health members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask for a pre-service organization determination before you receive the service. Please call our customer service or see your Evidence of Coverage for more information, including cost-sharing that applies to out-of-network services.