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Texas Department of Insurance
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Medicare advantage tips for providers

To help reduce the number of provider claims that may be denied because a patient switched to a Medicare Advantage plan, TDI offers these tips:

  • Post information in your office about the Medicare Advantage Plans your office does or does not accept.
  • Post TDI's consumer alert "Protect yourself against Medicare Advantage fraud"
  • Consider posting this publication from the Medicare website:

Providers also may wish to offer these tips, suggested by the Centers for Medicare & Medicaid Services (CMS), to their patients who are considering a Medicare Advantage plan:

  • PREPARE by gathering all of the information needed to make a decision about health and prescription coverage. This may include preparing a listing of medications, providers the patient wishes to see, and any notices received from the patient's plan regarding changes to costs or coverage for the next year.
  • COMPARE plans by visiting and searching for plans in the patient's area. The beneficiary should remember to think about the 3 C's: Cost, Coverage and Customer Service.
  • DECIDE which plan is right for their needs. If a change is necessary, the patient should call the plan they want to join. Medicare can also help the patient enroll – online, in person, or on the telephone. Beneficiaries should call 800-MEDICARE to determine if they qualify for low income assistance or if they feel they have been misled to enroll in a Medicare Advantage plan.

Questions? Call us at 800-252-3439.

Last updated: 8/25/2021