PDP
Who offers and provides coverage for Part D?
Private insurance companies
How long is the Open Enrollment (OE) time frame for Supplements?
6 months
What is the Initial Enrollment Period for Part B? (How do you qualify for it and what is the timeframe for a beneficiary to enroll)
When you are first eligible for Medicare you have a 7-month window to sign up for Part B. 3-1-3 (3 months before you are eligible, the month you become eligible, and 3 months after you are eligible)
What are the Parts of Original Medicare?
Part A and Part B
T/F: Disclosures and proper compliance are only important on calls that end in a sale.
False
What are the costs associated with a Prescription Drug Plan?
Copays, Premiums, Coinsurance and Annual Deductibles
What expenses should the client be prepared to pay with a Plan N in most states?
Part B deductible, up to $20 for an office visit, up to $50 for an ER visit, and any Part B excess charges
When/how do you become eligible for Original Medicare?
-Most people become eligible for Original Medicare when they turn 65 or after they have been disabled for 24 consecutive months. Also, people of any age with ESRD and Lou Gehrig's disease are eligible for Original Medicare.
What are the expenses associated with Medicare Part B?
20% coinsurance, $198 annual deductible, and $144.60/month premium for most people.
Name 2 FEATURES of SQS
Represents 20 of the top A-rated carriers in the United States / We are one of the largest insurance advisory firms for people with Medicare / We sell Medicare Supplements, Medicare Advantage Plans, Prescription Drug Plans as well as other products clients need (one-stop shop) / Agents are commission neutral – our commission is not based on carrier, plan, or price / SQ has an A+ Rating with the Better Business Bureau
What is the most a client will pay for their covered prescriptions while on Full Extra Help?
No more than: $3.60 for generic and $8.95 for brand name drugs.
What Medigap plan(s) is/are a client Guaranteed Issue for when in a Guaranteed Issue Window? Give 2019 & 2020 plans
A, B, C, F, K, L if eligible for Medicare before Jan 1, 2020. A,B,D,G,K & L if eligible for Medicare on or after Jan 1, 2020.
What is the enrollment period for beneficiaries who failed to sign up for Part B when they could have and when does it occur? When someone enrolls during this late period, when does their Part B coverage take effect?
General Enrollment Period- You can enroll from January 1st- March 31st. Part B coverage begins July 1st.
What is the Part B penalty and how does someone get it?
10% of the Part B premium for each 12-month period they could've had Part B but didn't and went without creditable coverage. The penalty stays with the beneficiary as long as they have Part B coverage.
What are the Four Parts to a Sales Call? (list them in order)
Introduction / Information Gathering / Pitch / Close
During Catastrophic Coverage, how much will the client pay for generic and for brand name drugs?
They will pay either 5% of the retail price OR $3.60 for generic drugs and $8.95 for brand name drugs, whichever is greater.
What are Part B Excess Charges?
The amounts that doctors are allowed to charge above the Medicare contracted allowable amount, up to 15%, if they do not accept Medicare Assignment.
During which enrollment period can you drop a PDP and move to Original Medicare alone or switch from one PDP to another? (Include dates)
Annual Enrollment Period - October 15th- December 7th
What is the cost of the Part A deductible in 2020 and how does the benefit period work?
$1,408 covers an inpatient stay for a benefit period that lasts 60 days post discharge.
How long is a value proposition? How often should you value prop during a call?
10-20 seconds. Should be sprinkled throughout the call
What is the Part D penalty? Why would one incur it and how is the amount determined?
A beneficiary will incur a Part D penalty if they fail to enroll for Part D coverage when first eligible and they do not have other creditable prescription drug coverage in place. If you are assessed a Part D penalty, you will pay an extra 1% of the National Average ($32.74 in 2020) on your monthly premium for each month you went without Part D coverage.
In order to have a Medigap plan in force what 3 things must you have/do?
Medicare Parts A&B, continue to pay your Part B premium, and must pay your Medigap Supplement premium.
You can switch your Medigap Policy surrounding the anniversary date of your policy in which state(s) without underwriting?
Missouri
List 2 services covered by Part A of Medicare and 2 services covered by Part B of Medicare.
Part A- inpatient hospital care, skilled nursing facilities, hospice care
Part B- outpatient care, doctors services, ER, ambulance, diagnostic tests, surgery center facility fees for approved procedures, Durable medical equipment
Make a PERSONAL value prop based on the client's situation: “I don’t like the Medicare plan I have now and want to switch”
Example: “Here at SelectQuote Senior, we represent more than 20 A-rated carriers. We're able to shop those carriers in your area to find you the most comprehensive coverage at the most affordable rate...and find you a plan that actually fits your needs. Talking to me is like talking to 20 agents at once; a one-stop-shop that helps you get your new coverage in place. And the best part about it: We will re-shop your plan each year to ensure that you continue to be in the plan that is most suitable to fit your needs and your budget in the future as well”