How to Enroll or Disenroll

Enrolling in L.A. Care Health Plan Medicare Advantage is easy. Since L.A. Care Health Plan Medicare Advantage HMO is a Dual Special Needs Plan (for Medicare Beneficiaries with Medicare and Full Medi-Cal Benefits), you can enroll anytime of the year. Simply...

• Call 1-888-4LA-CARE (1-888-452-2273) and a knowledgeable L.A. Care Health Plan representative will explain the plan and answer your questions. TTY users should call 1-866-522-2731. L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays.
• You have options on how you may enroll in L.A. Care Health Plan Medicare Advantage. You may choose to enroll via phone, mail or fax in your completed enrollment application, or schedule an appointment to meet with one of L.A. Care Health Plan Medicare Advantage representatives at your convenience.
• At your request, we will send you an information packet that includes an L.A. Care Health Plan Medicare Advantage Enrollment Form (PDF).
• Choosing your Primary Care Provider. To complete the Enrollment Form, you must pick a Primary Care Provider (PCP) and Medical Group/Clinic. You can use our "Find a Doctor or Hospital" online search or look at L.A. Care Health Plan Medicare Advantage Provider Directory to choose the Doctor and Medical Group that best suits your needs.
• Be sure to include Primary Care Provider (PCP) and Medical Group names and ID numbers on the Enrollment Form.
• Sign and date the Enrollment Form, keep a copy for yourself and mail the other copies to L.A. Care Health Plan in the envelope provided.

As your form is processed for approval, L.A. Care Health Plan will keep you informed in writing every step of the way. If you are approved for membership, your coverage will begin the first day of the month following the month we received your Enrollment Form. For example, if we received your Enrollment Form during the month of March, your coverage will begin April 1.

Disenrolling from Our Plan

Ending your membership in L.A. Care Health Plan Medicare Advantage may be voluntary (your own choice) or involuntary (not your own choice).

• You might leave our Plan because you have decided that you want to leave.  
       - Because you have both Medicare and Medi-Cal, you may voluntarily end your membership in the Plan at any time. Chapter 10, Section 2 in the Evidence of Coverage tells you when you can end your membership in the Plan.
       - The process for voluntarily ending your membership varies depending on what type of new coverage you are choosing. Chapter 10, Section 3 in the Evidence of Coverage tells you how to end your membership in each situation.
• There are also limited situations where you do not choose to leave, but we are required to end your membership. Chapter 10, Section 5 in the Evidence of Coverage tells you about situations when we must end your membership.

You may end your membership in our Plan anytime. All members have the opportunity to leave the Plan throughout the year. If you leave our Plan, your membership will end the last day of the month we receive the request.  Chapter 10, Sections 2 and 3 in the Evidence of Coverage tell you when and how you can end your membership in our Plan.


Until your membership ends, you are still a member of our Plan. If you leave L.A. Care Health Plan Medicare Advantage, it may take time before your membership ends and your new Medicare coverage goes into effect. During this time, you must continue to get your medical care and prescription drugs through our Plan.

When must we end your membership in the Plan? L.A. Care Health Plan Medicare Advantage 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 permanently or temporarily out of our service area for more than six months.
• 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.
• If you let someone else use your membership card to get medical care.
• You do not meet the Plan’s special eligibility requirements as stated in Chapter 1, Section 2.1 in the Evidence of Coverage (PDF).

We cannot ask you to leave our Plan for any reason related to your health.

You have the right to make a complaint if we end your membership in our Plan. If we end your membership in our Plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership. You can also look in Chapter 9, Section 10 in the Evidence of Coverage (PDF) for information about how to make a complaint.

For more information, call Member Services or see Chapter 10 in the Evidence of Coverage (PDF).

Disclaimer Information

L.A. Care Health Plan is a Medicare Advantage organization with a Medicare contract. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medi-Cal or by a third party. You must use plan providers except in emergent or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-plan providers, neither Medicare nor L.A. Care Health Plan will be responsible for costs. You must use network pharmacies to fill your prescriptions, except under non-routine circumstances when you cannot reasonably use network pharmacies.

Plan member materials are available in other formats (like braille, large type, audio) upon request.

For full information on L.A. Care Health Plan Medicare Advantage benefits, please call our Member Services department at 1-888-839-9909 (TTY 1-866-522-2731). L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays.