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You move outside our service area, or have experienced another change in circumstances — as determined by the Centers for Medicare & Medicaid Services (CMS) — that causes you to no longer be enrolled in the El Paso Health Medicare Advantage plan.
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You’re entitled to Medicare Part A and Part B and receive any type of assistance from the Title XIX (Medicaid) program.
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CMS or the organization has terminated our contract in the area in which you reside, or the organization has notified you of the impending termination or discontinuation of the plan in the area you reside.
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You demonstrate that we have substantially violated a material provision of our contract with CMS in relation to you, or we (or an agent) materially misrepresented the plan when marketing our plans.
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You weren’t adequately informed of the creditable status of drug coverage provided by an entity required to give such notice, or a loss of creditable coverage.
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Your enrollment or non-enrollment is erroneous due to an action, inaction, or error by a federal employee.
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You meet such other exceptional conditions as CMS may provide.
