WHA Care+

What Happens if WHA Care+ Leaves the Medicare Program?

WHA has a contract with the Centers for Medicare & Medicaid Services (CMS), the government agency that runs Medicare. This contract renews each year. At the end of each year, the contract is reviewed, and either WHA or CMS can decide to end it. It is also possible for our contract to end at some other time, too. You will get 90 days advance notice in this situation. If CMS must end our contract in the middle of the year, your advance notice may be as little as 30 days.

If we leave the Medicare program or change our service area so that it no longer includes the area where you live, we will tell you in writing. If this happens, your membership in WHA Care+ will end, and you will have to change to another way of getting your Medicare benefits. All of the benefits and rules described in the Summary of Benefits and Evidence of Coverage will continue until your membership ends. This means that you must continue to get your medical care in the usual way through WHA Care+ until your membership ends.

Your other healthcare choices will always include Original Medicare. Your choices may also include joining another Medicare managed care plan, or a Private Fee-for-Service plan, if these plans are available in your area and are accepting new members. Once we have told you in writing that we are leaving the Medicare program or the area where you live, you may change to another way of getting your Medicare benefits at any time. If you decide to change from WHA Care+ to Original Medicare, you will have the right to buy a Medigap policy regardless of your health. This is called a "guaranteed issue right". To find out more about Megigap coverage, you can contact HICAP at 2862 Arden Way, Suite 200, Sacramento, CA 95825 or call 1-800-424-0222. You can also find the website for HICAP at www.medicare.gov on the web.

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