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Did You Know? – Medicare Advantage

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  1. Where can I find a list of Medicare Advantage Plans?
  2. We have a patient who recently terminated her HMO coverage and does not know her Medicare Number. I've called the contact center and tried to verify eligibility, but am told they are unable to verify Medicare eligibility with only an HMO member number. What can I do?

    • The Provider Contact Center (PCC) must adhere to CMS guidelines and verify the patient's Medicare number, full name and date of birth prior to releasing information.

      Please note:The PCC will only verify eligibility if one of the following is unavailable: the Interactive Voice Response (IVR) Unit, the Direct Data Entry (DDE) eligibility function, or the myCGS web portal.

      Reviewed 09/22/2021
  3. Upon admission, patients will frequently present a traditional Medicare card and a Medicare Advantage card. What is the appropriate process for verifying their eligibility?

    • We encourage providers to ask their Medicare patients whether they have changed insurance each time they visit. If a member presents both a Medicare Advantage ID card and an original Medicare ID card, the provider should confirm Medicare Advantage eligibility and then disregard the original Medicare ID card.

      Reviewed 09/22/2021
  4. Where can I find out more about Medicare Advantage plans?

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