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Get Amerigroup Amerivantage Select (HMO) Individual Disenrollment Form 2018-2024

D form to: 1-800-833-8554 If you request disenrollment, you must continue to get all medical care from Amerivantage Select (HMO) until the effective date of disenrollment. Contact us at 1-866-805-4589 (Customer TTY users should call 711) to verify your disenrollment before you seek medical services outside of Amerivantage Select (HMO) s network. We are open 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holi.

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