On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact “a substantial proportion of people in America” and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 1-866-262-5342 regarding any questions.
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On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact “a substantial proportion of people in America” and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 1-866-262-5342 regarding any questions.
-
Shop for Plans
show Shop for Plans menu
- Plans & Enrollment
- Medicare Resources
-
I'm a Member
show menu
- Member Resources
- Services & Benefits
-
Pharmacy Benefits
show Pharmacy Benefits menu
- Pharmacy Resources
- Pharmacy Policies & Forms
Your Rights Upon Disenrollment |
Medicare Member Disenrollment
Do you want to disenroll from your Wellcare By Allwell Medicare plan? We’re sorry to see you go!
You can use the Disenrollment Form to disenroll from your Wellcare By Allwell Medicare plan. Note that if you request disenrollment, you must continue to get all medical care from your plan until the effective date of disenrollment. Contact Us to verify your disenrollment before you seek medical services outside of our network. We will notify you of the effective date of your disenrollment from the plan following receipt of this form.
Instructions
You may type to complete the:
Disenrollment Form English - (PDF)
Disenrollment Form Spanish - (PDF)
To do so, download and complete the form on your computer.
Please mail or fax your completed form.
For more information on disenrollment, including your rights and responsibilities upon disenrollment, refer to the following chapters in your Evidence of Coverage: Chapter 10 on Disenrollment and Chapter 8 on Member Rights and Responsibilities
Medicare Member Disenrollment
Do you want to disenroll from your Wellcare By Allwell Medicare plan? We’re sorry to see you go!
You can use the Disenrollment Form to disenroll from your Wellcare By Allwell Medicare plan. Note that if you request disenrollment, you must continue to get all medical care from your plan until the effective date of disenrollment. Contact Us to verify your disenrollment before you seek medical services outside of our network. We will notify you of the effective date of your disenrollment from the plan following receipt of this form.
Member Disenrollment Form
Are you a Wellcare By Allwell Medicare member who would like to disenroll from your coverage plan? Use this form to request a disenrollment. If you request disenrollment, you must continue to get all medical care from your plan until the effective date of disenrollment. Contact us to verify your disenrollment before you seek medical services outside of our network. We will notify you of your effective date following receipt of this form.
Note: To complete this form, you must have a valid disenrollment password. To obtain a disenrollment password, please Contact Us. One of our helpful Member Services representatives will speak with you about disenrollment and provide you with your password.
For more information on disenrollment, including your rights and responsibilities upon disenrollment, refer to the following chapters in your Evidence of Coverage: Chapter 10 on Disenrollment and Chapter 8 on Member Rights and Responsibilities.
If you have questions please, contact Member Services.
Please Note
By clicking on this link you will be leaving the plan website.