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Participating in Albright LIFE: Enrollment and Disenrollment

Enrollment
You, and if you wish, your family or caregiver, will meet with the program representative to review and come to an agreement about your participation in the Albright LIFE program before you sign an Enrollment Agreement.
At this meeting you have an opportunity to discuss:

  • The plan of care recommended for you by the health care team.
  • That when you are enrolled in Albright LIFE, all of your Medicare and Medicaid services must be authorized or coordinated by the health team. (Remember, approval is not required for emergency care.)
  • What to do if you are unhappy with the Albright LIFE program. You will be given information about the Participant Grievance Procedure.

Final Approval and Enrollment
If you decide to join Albright LIFE, we will ask you to sign the Enrollment Agreement. Upon signing this agreement, you will receive:

  • A copy of the Enrollment Agreement.
  • A sticker with Albright LIFE’s emergency telephone numbers and an instruction sheet to put on or by your telephone telling you what to do in an emergency.
  • An identification card that replaces your Medicare and Medicaid cards indicating that you are enrolled in Albright LIFE.

Since Albright LIFE provides comprehensive care for its participants, enrollment in Albright LIFE results in disenrollment from any other Medicare or Medicaid prepayment plan.

All Albright LIFE services are provided and admissions and referrals are made without regard to race, sex, color, national origin, ancestry, religious creed, sexual orientation, or handicap. Complaints of discrimination may be filed with the following state agencies:

Office for Civil Rights
U.S. Department of Health & Human Services
150 S. Independence Mall West
Suite 372, Public Ledger Building
Philadelphia, PA 19106-9111
Main Line (215) 861-4441
Hotline (800) 368-1019

Pennsylvania Human Relations Commission
Harrisburg Regional Office
Riverfront Office Center
1101-1125 S. Front Street, Fifth Floor
Harrisburg, PA 17104-2515
Voice (717) 787-9784
(TT/TTY) (717) 787-7279

Voluntary Disenrollment
Your social worker will assist you in transitioning your care to the appropriate Medicare and Medicaid Programs. You will need to sign a Disenrollment Form, which will indicate that you will no longer be entitled to services through Albright LIFE after midnight on the last day of the month.

Albright LIFE will make appropriate referrals and ensure medical records are made available to new providers within 30 days. Albright LIFE will work with CMS and the State administering agency to reinstate the participant in other Medicare and Medicaid programs for which the participant is eligible.

You may not disenroll from Albright LIFE at a Social Security office. Choosing to enroll in any other Medicare and Medicaid prepayment plan or optional benefit, including the hospice benefit, after you enrolled in Albright LIFE, is considered a voluntary disenrollment from Albright LIFE.

The Medicare or Medicaid program you enroll into upon disenrollment from Albright LIFE may not provide you with the full range of services available to you through Albright LIFE.

Involuntary Disenrollment
Albright LIFE can terminate your benefits, if:

  • You move out of the Albright LIFE service area.
  • You consistently do not comply with your individual care plan and/or terms of this agreement and are competent to make decisions for yourself.
  • You engage in disruptive or threatening behavior.
  • You fail to pay or fail to make satisfactory arrangements to pay any premium due to Albright LIFE after a 30-day grace period.
  • You are out of the service area for more than 30 days without prior approved arrangements.
  • You no longer meet the eligibility requirements for the program.
  • Our agreement with the federal and state government is terminated.
  • Albright LIFE loses the contracts and/or licenses enabling it to offer health care services.
  • Albright LIFE will make appropriate referrals and ensure medical records are made available to new providers within 30 days. Albright LIFE will work with CMS and the State administering agency to reinstate the participant in other Medicare and Medicaid programs for which the participant is eligible.

NOTE: In Pennsylvania, individuals who reside in personal care boarding homes are not nursing home eligible. Therefore, any individual who relocates to a personal care boarding home will be involuntarily disenrolled from the LIFE program.

  • Before you are involuntarily disenrolled from Albright LIFE, we will provide you with 30 days written notice. Your disenrollment will be effective the last day of the month after 30 days notice. During this time, LIFE participants must continue to use LIFE organization services and remain liable for any premiums. The LIFE organization will continue to provide all needed services.
  • Your involuntary disenrollment will automatically be considered an appeal if you are involuntary disenrolled for not complying with your care plan or meeting conditions of participation, engaging in disruptive or threatening behavior, failing to pay or make satisfactory arrangement to pay, or are out of the service area for more than 30 days without prior approved arrangements. An impartial party will review the involuntary disenrollment.
  • If you are disenrolled due to failure to pay the monthly fee, you can re-enroll simply by paying the monthly fee in full. Provided you make this payment before the effective date of disenrollment, there will be no break in coverage

Contact information for filing an appeal for disenrollment:

Alright LIFE Lycoming:
Phone number for oral requests: (570) 322-5433
Mailing Address for written requests: 901 Memorial Avenue, Williamsport, PA 17701
Fax number: (570) 327-3093
Executive Director Email: Pamela.Kennedy@AlbrightCare.org

Alright LIFE Lancaster:
Phone number for oral requests: (717) 381-4320
Mailing Address for written requests: 417 W. Frederick Street, Lancaster, PA 17603
Fax number: (717) 381-4380
Executive Director Email: Pamela.Kennedy@AlbrightCare.org

Alright LIFE Lebanon:
Phone number for oral requests: (717) 376-1133
Mailing Address for written requests: 113 S. 9th Street, Lebanon, PA 17042
Fax number: (717) 376-1450
Executive Director Email: Pamela.Kennedy@AlbrightCare.org