Disenrollments 

Voluntary disenrollments

You may request at any time, to leave or disenroll from Fallon Health Weinberg-MLTC plan. You can make a verbal or written request and the program will send a written confirmation letter about your disenrollment.

We will ask you to complete and sign a Voluntary Disenrollment Form and send it to us. 

Disenrollments are effective on the last day of each month after the request for the disenrollment is received. The member will remain enrolled in Fallon Health Weinberg and be fully covered until the last day of the month. The MLTC plan must continue to arrange services for you until the disenrollment takes place, and must also help you transfer to other long term care services.

Involuntary disenrollments

A plan may involuntarily disenroll you without your permission for certain reasons. These include, but are not limited to:

  • Moving outside of the plan’s service area
  • You lose your right to receive benfits from the Medicaid program.
  • You are hospitalized or enter an Office of Mental Health or Office of Alcohol and Substance Abuse residential program for 45 days or longer.
  • Behaving in a way that prevents the plan from providing the care you need
  • Failing to pay your spend-down, if you have one
  • You are outside the service area for more than 30 days.

If you need nursing home placement and are not eligible for institutional Medicaid, you will also be disenrolled from the plan.

If the plan tells you it will disenroll you and you disagree with this decision, your rights will be explained to you.

Take the next step

Contact us

1-716-250-3100
1-866-882-8185 (TTY 711)

8 a.m.–5 p.m., Monday–Friday

Member information

Member Handbook (pdf) ►

Overview of benefits and services ►

Contact us

1-866-882-8185 
8 a.m.–5 p.m., Monday–Friday