2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 10: Ending your membership in the plan 238 · If you are hospitalized on the day that your membership ends, your hospital stay will be covered by our plan until you are discharged (even if you are discharged after your new health coverage begins). Section 4 We must end your membership in the plan in certain situations Section 4.1 When must we end your membership in the plan? We must end your membership in the plan if any of the following happen: · We are notified that you no longer meet the eligibility requirements of your former employer, union group or trust administrator (plan sponsor). · Your former employer, union group or trust administrator’s (plan sponsor’s) contract with us is terminated. · If you no longer have Medicare Part A and Part B. · If you move out of our service area. · If you are away from our service area for more than 6 months. · If you become incarcerated (go to prison). · If you are no longer a United States citizen or lawfully present in the United States. · If you lie 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. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.) · 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. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.) · If you let someone else use your UnitedHealthcare member ID card to get medical care. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.) - If we end your membership because of this reason, Medicare may have your case investigated by the Inspector General. · If you are required to pay the extra Part D amount because of your income and you do not pay it, Medicare will disenroll you from our plan and you will lose prescription drug coverage. Where can you get more information? If you have questions or would like more information on when we can end your membership call Customer Service. Section 4.2 We cannot ask you to leave our plan for any health-related reason Our plan is not allowed to ask you to leave our plan for any health-related reason.