Hospital SEP?

[Fisher]

If a hospital leaves an MAPD network does that create an SEP for the MAPD policyholders? I feel like I should know this but I've got AEP mushbrain.

 

[goillini52]

If a hospital leaves an MAPD network does that create an SEP for the MAPD policyholders? I feel like I should know this but I've got AEP mushbrain.

I'll guess no.

 

[straightnochaser]

If a hospital leaves an MAPD network does that create an SEP for the MAPD policyholders? I feel like I should know this but I've got AEP mushbrain.

There is but it is limited to 1-800 Medicare, not available to agents.

 

[rmhaire]

If a hospital leaves an MAPD network does that create an SEP for the MAPD policyholders? I feel like I should know this but I've got AEP mushbrain.

You do. And yes it does.

Losing is losing. You can even call it a dyslexic SEP.

 

[Fisher]

There is but it is limited to 1-800 Medicare, not available to agents.

Source please.

 

[straightnochaser]

Source please.

https://www.medicareinteractive.org/pdf/SEP-Chart.pdf

Number 19.

CMS makes the determination if the loss of providers is substantial enough to warrant an SEP and the carrier then sends a notice to the member.

 

[DonP]

Source please.

Theres no sept for hospital or drs leaving networks . What the posters saying a beneficiary could argue great harm from either and possibly get a special sep from medicare directly

 

[straightnochaser]

Theres no sept for hospital or drs leaving networks . What the posters saying a beneficiary could argue great harm from either and possibly get a special sep from medicare directly

Technically there is but it’s not available to us, I would just use DST if available.