How Can I Make Sure I Don’t Lose My Coverage?

Healthy Way LA » Member Handbook » How Can I Make Sure I Don’t Lose My Coverage?

Keeping Your HWLA Eligibility
To stay in HWLA, you must be eligible for it. “Eligible” means that a person meets certain requirements to receive benefits from programs like HWLA. HWLA will check to make sure you still meet the requirements for HWLA membership once per year.

If you lose HWLA eligibility, you will not be able to keep your benefits with HWLA.

Be sure to fill out and return any information requested before the due date on the letter or form. If you have any questions about your eligibility, call your medical home. Your membership in HWLA lasts one year. Every year you need to renew your membership with your medical home. Your medical home will ask you to bring in current income documentation to see if you are still eligible for HWLA.
If You Move, You Must Tell Us!
Don’t lose your HWLA coverage if you move! HWLA must have your address so they can send you mail to renew and stay eligible.

If you move but still live in Los Angeles County, please:

  • Call your medical home right away. They will need to see proof of your new address (e.g., utility bill); OR
  • Call HWLA Member Services. They will explain to you what you need to do.
Disenrollment
To “disenroll” means you leave HWLA and are no longer a member.
Voluntary Disenrollment
Voluntary disenrollment is when you choose to end your membership in HWLA for any reason. If you want to disenroll from HWLA, call Member Services or your medical home. They will send you a disenrollment letter with a date of disenrollment on it. You may continue to receive services through HWLA until your date of disenrollment.
Involuntary Disenrollment
Involuntary disenrollment is when you are disenrolled for a reason other than your own choice. You will lose coverage with HWLA, if any of the following happens:

  • You move out of Los Angeles County
  • You turn 65 years of age
  • You do not renew your membership every year
  • You become eligible for Medi-Cal
  • You start to have more income than the maximum allowable income for HWLA

You can also be disenrolled from HWLA, if:

  • You take part in any fraud having to do with services, benefits or facilities of the plan.
  • HWLA Program is not able, in good faith, to give health care services to you. HWLA Program will use their best efforts to provide the needed services.

If you are disenrolled from HWLA, we will send you a letter that says when your coverage will end and why. You may file an appeal by following the directions under “How to File an Appeal” in the Complaints section of this handbook.
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