To speak with a licensed agent call 1-844-324-0691 (TTY 711)

Rights for Disenrollment


To learn more about both voluntary and involuntary disenrollment, please read through the content below.

Your Rights and Responsibilities Upon Disenrollment

"Disenrollment" means leaving Vibra Health Plan and no longer being a member. You can choose to disenroll from Vibra Health Plan (voluntary disenrollment) during the annual Medicare Disenrollment period from January 1-February 14. In certain situations, Vibra Health Plan can disenroll you (involuntary disenrollment).

Voluntary disenrollment:

  • In most cases, you can leave our plan simply by enrolling in another health plan during an available election period. Any member can disenroll during Medicare’s Annual Election Period, October 15 – December 7.
  • If you want to switch from one of our plans including prescription drug coverage to Original Medicare, which does not have a prescription drug plan, you must contact Vibra Health Plan Member Services and ask to be disenrolled. Or, you can call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
  • Note: If you disenroll from Medicare prescription drug coverage and go without creditable prescription drug coverage, you may need to pay a late enrollment penalty if you join a Medicare drug plan. (Creditable coverage means coverage that is expected to pay at least as much as Medicare’s standard prescription drug coverage, on average).

Involuntary disenrollment:

  • If you move out of our service area or are gone from it for more than six consecutive months or if we no longer offer the plan in your geographic area, you will be disenrolled. You can then go to Original Medicare, or if you qualify for a Special Enrollment Period, you could choose a new plan.
  • If you fail to pay your plan premium or any late enrollment penalty, you could be disenrolled. You can then go to Original Medicare, or if you qualify for a Special Enrollment Period, you could choose a new plan.
  • If we end your membership in our plan, we must tell you our reasons in writing for ending your membership. We must also explain how you can make a complaint about our decision to end your membership.

Loading

Leaving so soon?

We want to make sure that you know you are exiting our site and going to an external website.

Be the first to know!

Be the first to know about Pennsylvania’s newest health insurance option.


Thank you for sharing your contact information and preference. We look forward to sharing more information about Vibra Health Plan and our insurance options when it becomes available.

Whoops! Something went wrong. We apologize for the inconvenience. Please try to submit your information again.

Sign Up
Preferred method of contact

Tell us where you live.

Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov.

To view your coverage options, enter your zip code and county below.

Your location

We're sorry, but you have either entered an incorrect zip code or you are out of our service area.

Required field

Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

Before you enroll

To make sure you are eligible we'll need a few more pieces of information.

Before your enroll

You must have Medicare Part A and Part B to join a Medicare Advantage Plan.

Generally you are not eligible to enroll in our plan if you have been medically determined to have ESRD. If you have had a successful kidney transplant and/or you don’t need regular dialysis any more, you are eligible to enroll, we will need to contact you to obtain additional information.

Are you new to Medicare?

Are you already entitled to Part A and enrolled in Part B?

Do you have end-stage renal disease ESRD?

If you have had a successful kidney transplant and/or you don't need regular dialysis any more, please mail a note or records from your doctor showing you have had a successful kidney transplant or you don't need dialysis, otherwise we may need to contact you to obtain additional information.

Vibra Health Plan, Inc.

4000 Crums Mill Rd.

Suite 201

Harrisburg, PA 17112
To speak with a licensed agent call 1-844-324-0691 (TTY 711)

8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)

Previous

View Plan Options

Please select one of our coverage options below.

Your options
Plan Monthly Premium Primary Care Copay Out-of-pocket Max Select
Essential Coverage PPO$0In $10 | Out $35$6,700
Enhanced Coverage PPO$49.50In $5 | Out $25$4,800

Do you want to add optional dental coverage?

Your monthly rate will increase by $33.30.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

Your monthly rate will increase by $28.00.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

Previous

Ready to Enroll?

It looks like you are interested in the plan outlined below. By clicking the “Enroll Now” button, you are confirming your intent to complete an actual enrollment request to join Vibra Health Plan.

You will want to have your Medicare card available to help complete the application.

If you need assistance during this process, our contact information is listed below.

Plan Breakdown

  • Primary Care Copay In $10 | Out $35
  • Out-of-pocket Max $6,700

Estimated monthly payment:

  • Monthly Premium $0
  • Monthly Dental Premium (Optional) $33.30

  • Monthly Total ${[{ mec.formatMonthlyTotal('Essential_Coverage_PPO') }]}
  • Primary Care Copay In $5 | Out $25
  • Out-of-pocket Max $4,800
  • Monthly Premium $49.50
  • Monthly Dental Premium (Optional) $28.00

  • Monthly Total ${[{ mec.formatMonthlyTotal('Enhanced_Coverage_PPO') }]}
Previous

Important Information

You may enroll in only one Medicare Advantage Plan at a time.

You may join or leave that plan only at certain times of the year or in special circumstances.

The Annual Election Period occurs October 15 through December 7. During this time, eligible individuals may enroll in or change Medicare Advantage Plans. Coverage will begin January 1.

Other Enrollment Methods

Fax: 1-844-260-7923
For Phone Applications (please call to speak with a licensed agent)
Phone: 1-844-324-0691 (TTY 711)
Phone: 1-800-MEDICARE (1-800-633-4227)
Hours: 8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)
Online: Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

Note

You must continue to pay your Medicare Part B premium.

Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.


Last Updated Nov. 11th, 2016 (H9408_17_49134_Webenroll Approved)

Tell us where you live.

Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov.

To view your coverage options, enter your zip code and county below.

Your location

We're sorry, but you have either entered an incorrect zip code or you are out of our service area.

Required field

Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

Before you enroll

To make sure you are eligible we'll need a few more pieces of information.

Before your enroll

You must have Medicare Part A and Part B to join a Medicare Advantage Plan.

Generally you are not eligible to enroll in our plan if you have been medically determined to have ESRD. If you have had a successful kidney transplant and/or you don’t need regular dialysis any more, you are eligible to enroll, we will need to contact you to obtain additional information.

Are you new to Medicare?

Are you already entitled to Part A and enrolled in Part B?

Do you have end-stage renal disease ESRD?

If you have had a successful kidney transplant and/or you don't need regular dialysis any more, please mail a note or records from your doctor showing you have had a successful kidney transplant or you don't need dialysis, otherwise we may need to contact you to obtain additional information.

Vibra Health Plan, Inc.

4000 Crums Mill Rd.

Suite 201

Harrisburg, PA 17112
To speak with a licensed agent call 1-844-324-0691 (TTY 711)

8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)

Previous

Almost there.

Thank you for adding some of your information. You can now download our enrollment application.

We are unable to accept online enrollments at this time. Please check back on October 15, or feel free to download the paper application. Applications should be mailed to:

PO Box 60250,
Harrisburg, PA 17106
Fax: 1-844-260-7923

To speak with a licensed agent, please call 1-844-324-0691 (TTY 711).


Important Information

You may enroll in only one Medicare Advantage Plan at a time.

You may join or leave that plan only at certain times of the year or in special circumstances.

The Annual Election Period occurs October 15 through December 7. During this time, eligible individuals may enroll in or change Medicare Advantage Plans. Coverage will begin January 1.

Other Enrollment Methods

Fax: 1-844-260-7923
For Phone Applications (please call to speak with a licensed agent)
Phone: 1-844-324-0691 (TTY 711)
Phone: 1-800-MEDICARE (1-800-633-4227)
Hours: 8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)
Online: Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

Note

You must continue to pay your Medicare Part B premium.

Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.


Last Updated Nov. 11th, 2016 (H9408_17_49134_Webenroll Approved)