Yes, you can ask to change your Insurer. Once you have chosen an Insurer or one has been chosen for you, you have ninety (90) days to change your Insurer. You can also change your Insurer once a year during the “Open Enrollment Period”, which is from November 1 to January 31.
If you want to change your Insurer, call the Enrollment Counselor at 1-833-253-7721, Monday through Friday, 8:00 a.m. to 6:00 p.m. TTY/TDD Spanish users should call at 1-866-280-2050, and for TTY/TDD English users should call at 1-866-280-2053 or visit your local Medicaid Office. You can also visit the webpage www.planvitalpr.com
You can also ask to change your Insurer at any time if you have certain reasons, like:
- You are not able to access services or providers.
- You cannot get all related services that you need at one time from the doctors, healthcare professionals and service facilities that work with your Insurer.
- You get poor-quality care.
- You ask for a service that your Insurer does not cover because of moral or religious reasons.
- Your Insurer does not have doctors that are experienced in dealing with your health care needs.
If you want to change your Insurer for one of these reasons, you can ask for this change from the Enrollment Counselor or ASES. ASES will decide if you can change your Insurer or if you have to wait until Open Enrollment Period. If you do not like the decision ASES makes, you can ask them to reconsider. If the decision is still not to your liking, you can ask for an Administrative Law Hearing.