How to Cancel Summit HMO

Annual support by state governments for elderly citizens' healthcare insurance can determine the quality of care for recipients. However, a conflict of interest can occur when doctors participating in a health maintenance organization (HMO) make decisions to cut back based on the incentive goals of the group. Recipients suffer. If a compromise cannot be made, participants have the right to voluntarily terminate their HMO membership.



Group members participating in Summit HMO, sponsored by Coventry Health Care, can voluntarily terminate participation in the HMO during open enrollment. Voluntary termination of Summit HMO can lead to enrollment with another Medicare Advantage plan or supplement or participation in a preferred provider organization (PPO). Members have a choice. Several groups are available and actively seeking more members.

Things You'll Need

• Recipient number
• Notice of termination
• Appointment of Representative form

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Instructions

• 1

  Determine reason for termination. Even though voluntary termination is allowed, be sure to provide proof of request for resolution and any documentation you have for terminating your Summit HMO membership.

• 2

  Fill out the Appointment of Representative form. If you are experiencing a legal issue or would like to go through an attorney, you must complete the Appointment of Representative form to grant the representative authority to represent you.

• 3

  Use the Center for Medicare and Medicaid Services website, the CMS website, to locate the address for the regional office which serves your local area.

• 4

  Mail request for termination to CMS. Mail the request for termination and other documents to CMS during open enrollment from November 15 to December 31.

• 5

  Wait for confirmation of termination and keep record of all documents. You should receive documentation noting your request for termination from Summit HMO within three to four weeks.