Election Periods
When is the Open Enrollment Period (OEP)?
January 1st - March 31st
When you are Guaranteed Issue, Supplements will cover all expenses even if Medicare won't pay.
False - Supplements will only cover what Medicare covers.
What are the two disclosures you must give on every phone call?
-Licensed sales agent in the state of _______ -Call is being recorded for quality assurance
T or F. Open Enrollment = Triggered by Part B effective date
True
A PFFS is a hybrid of what?
Medigap and Medicare Advantage plans
What parts of Medicare must you have in order to join an MAPD plan?
Medicare Part A and B
Are there networks associated with Medigap plans?
No - they can see any doctor that accepts Original Medicare.
During your sales call, it is important to create a sense of ___________________
URGENCY!
List three things are not covered by any Medicare Supplement plan?
Prescriptions, Long Term Care, Dental, Vision.....
Medicare is health insurance for:
People 65 years old and older, People under 65 with certain disabilities, People of any age with End Stage Renal Disease (ESRD)
What triggers the Initial Enrollment Period and how long does it last?
IEP is triggered by new to Medicare Part A & B; it is a 7 month period that starts 3 months before the month of eligibility, the month they become eligible and 3 months following.
During which Supplement Election Period (OE or GI) does a client have to go through Medical Underwriting?
Neither - they only have to go through Underwriting if they miss their OE and don't have a GI window
What does KISS stand for, as defined in your manual?
Keep It Successfully Simple
T or F. GI = Triggered by involuntary loss of creditable coverage.
True
Josh turns 65 in December and was born December 1, 1954. When will his Part A begin?
November 1, 2019
T/F: The Annual Enrollment Period applies to Medigap plans
FALSE. The AEP does not apply to Medigap plans- AEP alone does not make a client GI for a Medigap plan.
What is the time frame for Open Enrollment (OE)?
OE is 6 months triggered by: New to Part B (or turning 65) and the following 5 months following.
What are the four key parts to a sales call - in order?
Introduction, Information Gathering, Pitch, Close
List the Election Period Hierarchy
IEP/ICEP
SEP
AEP/OEP
T/F Medicare Advantage plans are supplemental coverage
FALSE. Medicare Advantage plans REPLACE the Original Medicare benefit structure.
Clark enrolls in Part B using the General Enrollment Period, when will his Part B begin?
July 1st
Jerry is 68 and on a Medicare Supplement plan in the state of Ohio. He is moving to Texas next month. Will he lose his Medicare Supplement plan due to his move?
No - Medicare Supplement plans will cover you nationwide and will move with you.
*In the event the carrier terminates their plan, they would be GI to get a new plan*
Prior to discussing Medicare Advantage or Prescription Drug Plans, you MUST say the following disclaimers:
Can I have your permission to discuss Medicare Advantage plans with you? Before we continue please be aware that you are not required to provide any information you don't want to, and that any information you do provide during this call will not affect your ability to request enrollment or affect your plan membership. Have you been diagnosed with End Stage Renal disease or are you receiving renal dialysis? (MAPD only)
Clark is 70 yrs old and retiring and losing employer coverage at the end of November, he deferred Part B while he was working. He applies for Part B to start in December and calls you to get an MAPD. Which Election Periods is he eligible for to enroll into an MAPD? Which one should he use?
ICEP, SEP & AEP. He should use ICEP based on the Election Period Hierarchy.
What $ amount causes the client to enter Catastrophic Coverage and what will the beneficiary pay while in Catastrophic Coverage?
$5,100 The greater amount of 5% of the retail price OR $3.40 for generic drugs $8.50 for brand name drugs