Hospital SEP?
- Thread starter Fisher
- Start date
- 30,398
I'll guess no.
- 1,138
There is but it is limited to 1-800 Medicare, not available to agents.
- Thread starter
- #5
Source please.
- 1,138
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.
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
- 1,138
Technically there is but it’s not available to us, I would just use DST if available.
I don't see where it is limited to calling CMS, But it does say the carrier will send a letter IF it is determined if it is substantial
Its not specific to a hospital leaving network but it does say someone will decide and no notice no SEP
Your plan will mail you a notice if CMS determines the terminations are substantial.
- Thread starter
- #10
Yep, same chart I've used for years. #19 has too much wiggle room to give a conclusive answer to the question. Thanks though.
