Part A
What is Part A of Medicare?
Hospital
What is Part B of Medicare?
Medical(Doctors)
What is Part C of Medicare?
Medicare Advantage
What is Part D of Medicare?
Drugs
Another name for a Medicare Supplement?
Medigap
Name 2 things covered by Part A.
Inpatient Hospital, Skilled nursing, hospice, blood, & home health care
Name 2 things covered by Part B.
Doctor services, outpatient services, DME, preventative services, labs/imaging, drugs administered at facility, and ambulance
Name the 3 networks used for Part C.
HMO, HMOPOS, PPO
What are the three coverage stages for Part D.
Initial, Deductible, and Catastrophic
True or False: All medicare supplement plans come with a Household/multi insured discount
False...only some carriers offer the discount
What is the Part A Deductible for 2026?
$1736
What is the Part B deductible for 2026?
$283
What Part C plan is best for someone on both Medicare and Medicaid?
DSNP
What is the Part D cap limit for 2026?
$2100
Name the 2 plan letters that offer a High Deductible option.
F & G
What is maximum amount of days covered in a Skilled Nursing Facility?
100 days, but can be cut off at any time if not showing signs of improvement or refusing to participate
True or False: IRMAA only affects the Part B premium.
False...affects Part B & D
True or False: You only need a Scope of appointment for Part C
False... Scope of Appointments are for both Part C & D
What does TROOP stand for in regards to Part D coverage?
True Out of Pocket Cost
It is basically the cap limit or the MOOP for drug coverage. It tracks the amount a person has paid towards covered drugs on the plan and when they will hit the catastrophic phase. Only deductibles and copayments paid by the person goes towards this amount, any premiums or drugs not on the formulary do not count towards TROOP
Name the 3 things not covered under Plan N.
Part b deductible, excess charges, and possible copay up to $20 for dr visit and up to $50 for ER
True or False: Part A covers Hospice 100%
True
Name 2 life changing events that would be eligible for an IRMAA appeal
Work stoppage/reduction, Marriage, divorce, death of spouse, loss of income producing property, loss of pension income, or employer settlement payments.
How much time is given for the chronic verification for CSNP plans, and what happens if it is not verified by the deadline?
They give 2 months to verify the conditions once plan goes into effect, and if it is not verified by that deadline they will be disenrolled from the plan.
What happens if someone has already hit the cap limit on their current plan, but decides to changes coverage in the middle of the year, does the cap limit reset or follow to the new coverage?
The catastrophic status will follow over to the new coverage if the cap limit has been reached for that year.
Who is eligible for open enrollment for Medicare supplements?
Someone turning 65 or someone who has delayed part b with credible coverage