Leaving the Plan (Disenroll)

Losing your benefits

You will lose your AmeriHealth Caritas Delaware benefits (be disenrolled from AmeriHealth Caritas Delaware) if:

  • You are no longer eligible for Medicaid or AmeriHealth Caritas Delaware.
  • You move out of the state of Delaware service area.
  • Your condition or illness could be better cared for by another plan. (You will not automatically lose your coverage with us if your condition can be treated better by another health plan.)
  • There is evidence you have engaged in fraud, forgery, or unauthorized use or abuse of medical services.
  • You reached the effective date of your requested disenrollment (see below for when you can ask to disenroll).
  • You enroll in a program that is not eligible for the Diamond State Health Plan.
  • You do not complete the required re-enrollment paperwork.
  • You become an inmate of a public institution.

You will not lose your AmeriHealth Caritas Delaware benefits if:

  • You have changes to the state of your health.
  • You are using more health care services.

You can ask to be disenrolled from AmeriHealth Caritas Delaware:

  • For cause, at any time. A cause includes, but is not limited to:
    • You move out of the state of Delaware service area.
    • You are not able to access covered services or providers.
    • You receive poor-quality care.
    • You request service that AmeriHealth Caritas Delaware does not cover because of moral or religious objections.
    • At any time if you are unable to get all related services you are requesting at one time, within the AmeriHealth Caritas Delaware network, to avoid unnecessary risk to you.
    • At any time if the state sanctions the plan, resulting in temporary management or the plan having to pay a financial penalty.

Disenrollment from AmeriHealth Caritas Delaware is effective on the first day of the following month.

If you have questions about Medicaid, please contact the Delaware Medicaid Customer Relations department at 1-866-843-7212 or 1-302-571-4900.

If you have questions about AmeriHealth Caritas Delaware, please call AmeriHealth Caritas Delaware Member Services, 24 hours a day, seven days a week, at:

  • Diamond State Health Plan: 1-844-211-0966 (TTY 1-855-349-6281).
  • Diamond State Health Plan-Plus: 1-855-777-6617 (TTY 1-855-362-5769).
Members