You may end your membership in your plan only during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Enrollment Period (AEP) and during the Medicare Advantage Open Enrollment Period (MA OEP). In certain situations, you may also be eligible to leave the plan at other times of the year.
How to Disenroll
You can disenroll from your Imperial Health Plan Medicare Advantage plan in any of the following ways:
- Complete the Disenrollment Form below and submit it by fax to 1-866-525-7136 or by mail to PO Box 60874, Pasadena, CA 91116. You may also request the form by calling Member Services.
- Write a letter to the plan requesting to disenroll and submit it by fax to 1-866-525-7136 or by mail to PO Box 60874, Pasadena, CA 91116.
- Enroll in another plan during a valid enrollment period. Your enrollment in the new plan will automatically end your current membership.
- Call 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048, and request to disenroll.
When You Can Disenroll
Disenrollment is only permitted during specific enrollment periods. The main windows are:
- Annual Enrollment Period (AEP) — October 15 through December 7 each year. Changes take effect January 1 of the following year.
- Medicare Advantage Open Enrollment Period (MA OEP) — January 1 through March 31. You may switch to Original Medicare or a different Medicare Advantage plan.
- Special Enrollment Periods (SEPs) — Certain life events may qualify you to disenroll outside of standard enrollment periods. Contact Member Services to determine whether you qualify.
Member Services
PO Box 60874, Pasadena, CA 91116
Page last updated: September 2, 2026 at 12:00 PM PST (Build v5.7.127)
Imperial Health Plan is an (HMO) (HMO SNP) with a Medicare Contract. Enrollment in Imperial Health Plan depends on contract renewal.
Imperial Health Plan of California (HMO) (HMO SNP) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Imperial does not exclude anyone or treat them unfairly because of race, color, national origin, age, disability, or sex. ATTENTION: If you speak English, free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call 1-800-838-8271 (TTY: 711) or speak to your provider.