I don't see any sep notices in emails mentioning Texas. I also don't think there are any 5 star plans but I'm not at a computer.
Help me solve this problem!
- Thread starter shonceman
- Start date
I don't see any sep notices in emails mentioning Texas. I also don't think there are any 5 star plans but I'm not at a computer.
I am still wondering what a Medicare Replacement Card is. Nowhere is Medicare Advantage mentioned in the provider's letter.
margostl
Super Genius
- 186
I do see a ongoing Sep for Collin County from Cigna.Received 12-04
Hope this helps
Declaration information RENEWED
State declaration: Wildfires
SEP incident dates: 07/24/2023 – Ongoing
This SEP declaration is effective: 07/24/2023 – Ongoing Impacted counties for SEP purposes: Armstrong, Bailey, Baylor, Borden, Brewster, Briscoe, Brooks, Cameron, Carson, Castro, Cochran, Collin, Crockett, Culberson, Dimmit, Donley, Duval, Ector, El Paso, Garza, Glasscock, Gray, Hale, Hall, Haskell, Hemphill, Hidalgo, Hudspeth, Jack, Jasper, Jeff Davis, Jim Hogg, Kenedy, King, Kinney, Knox, LaSalle, Lamb, Lipscomb, Martin, Maverick, Medina, Mitchell, Moore, Newton, Nolan, Oldham, Potter, Presidio, Reagan, Reeves, Refugio, Roberts, San Patricio, Scurry, Sherman, Starr, Stonewall, Terrell, Throckmorton, Upton, Val Verde, Ward, Webb, Wheeler, Wilbarger, Willacy, Winkler, Wise, Zapata, and Zavala
Hope this helps
Declaration information RENEWED
State declaration: Wildfires
SEP incident dates: 07/24/2023 – Ongoing
This SEP declaration is effective: 07/24/2023 – Ongoing Impacted counties for SEP purposes: Armstrong, Bailey, Baylor, Borden, Brewster, Briscoe, Brooks, Cameron, Carson, Castro, Cochran, Collin, Crockett, Culberson, Dimmit, Donley, Duval, Ector, El Paso, Garza, Glasscock, Gray, Hale, Hall, Haskell, Hemphill, Hidalgo, Hudspeth, Jack, Jasper, Jeff Davis, Jim Hogg, Kenedy, King, Kinney, Knox, LaSalle, Lamb, Lipscomb, Martin, Maverick, Medina, Mitchell, Moore, Newton, Nolan, Oldham, Potter, Presidio, Reagan, Reeves, Refugio, Roberts, San Patricio, Scurry, Sherman, Starr, Stonewall, Terrell, Throckmorton, Upton, Val Verde, Ward, Webb, Wheeler, Wilbarger, Willacy, Winkler, Wise, Zapata, and Zavala
- Thread starter
- #14
- 4,040
It seems to be a layman’s term for MA.
[EXTERNAL LINK] - Medicare replacement plans: Medicare Advantage, benefits, and more
- 6,473
That is a consistent thing I have seen mentioned in posts here and in sales training, Medicare Advantage members need to put away their original Medicare card and use the card provided by the MA plan. I expect that's where the concept of "replacement" comes from.
That's what CW says in some of his videos . . . he probably coined the phrase
Does the doc in question have an office full of Christian decor and drives a purple corvette? I’ve already gotten 2 calls on this.
I’m way too tired to read the comments, so if I’m repeating…well. Deal. I’m still doing ACA.
1. Medicare Advantage was originally called Medicare Replacement. Hence the phrase “assigning your rights from Original Medicare over to the private company”
2. There is an SEP in Collin County for MAPD but she does not qualify
3. Technically, doctors cannot do this. I can’t find the damn contract (haven’t looked too hard) but I turned in 2 different family practice offices in the area and got new letters sent PDQ. Both clients have asked me not do anything until January, so they can have their Dec appts
4. Look at Baylor for new pain management docs, they will all take OM
5. Have her talk to the original referring doc for suggestions on new docs.
6. Get the appt at the new doc for Jan NOW. As in by and of day Monday.
7. Ask for 90 days to transition at the last appointment
8. Pain Management under MA is a nightmare of prior authorization. I have a lot of Under 65s on MAPD (TX only has Plan A as an option) and it’s their #1 complaint
9. It’s my understanding that the letter gives a cash option. The doc is NOT opting out of Medicare, he’s being a jerk. Filing claims should be an option. But again, I haven’t dug in on the legal side.
Hope this helps!
I’m way too tired to read the comments, so if I’m repeating…well. Deal. I’m still doing ACA.
1. Medicare Advantage was originally called Medicare Replacement. Hence the phrase “assigning your rights from Original Medicare over to the private company”
2. There is an SEP in Collin County for MAPD but she does not qualify
3. Technically, doctors cannot do this. I can’t find the damn contract (haven’t looked too hard) but I turned in 2 different family practice offices in the area and got new letters sent PDQ. Both clients have asked me not do anything until January, so they can have their Dec appts
4. Look at Baylor for new pain management docs, they will all take OM
5. Have her talk to the original referring doc for suggestions on new docs.
6. Get the appt at the new doc for Jan NOW. As in by and of day Monday.
7. Ask for 90 days to transition at the last appointment
8. Pain Management under MA is a nightmare of prior authorization. I have a lot of Under 65s on MAPD (TX only has Plan A as an option) and it’s their #1 complaint
9. It’s my understanding that the letter gives a cash option. The doc is NOT opting out of Medicare, he’s being a jerk. Filing claims should be an option. But again, I haven’t dug in on the legal side.
Hope this helps!
- Thread starter
- #18
- 4,040
That’s very helpful! (Yes, it could be the same doc as your 2 callers).
- 16,907
I would have to assume the doctor is being suspected of Medicare fraud or something and is trying to get off the radar.
Had not considered that angle, but it makes more sense than other speculations.
OM is simple to administer on the provider side and OM/Medigap generally pay quicker than MA plans . . . so why would a provider want to limit the practice to managed care and cash only?
