A
Begins 3 months before the individual's 65th birthday, includes the month they turn 65, and ends 3 months after the month they turn 65.
What is IEP(ICEP)
You can sign up for a stand-alone prescription drug plan only if you have BOTH Medicare parts A and B.
What is False
Certain events allow you to make a change to your Med. Adv. coverage during the year. For example, if you move outside of your plan's service area or lose your employer coverage you may be eligible for a:
What is Special enrollment period(SEP)
how much is the part b premium?
$174.70
This is Florida Blue's PPO plan with a $0 premium
What is Value PPO
The part a benefit period resets after how many days from being discharged from the hospital?
60 days
The amount you pay before your health insurance plan begins to pay its share of the cost.
Deductible
This type of medicare advantage plan has a higher cost share but is richer in benefits
What is PPO
This plan has lower costs but requires members to go within the plan's provider network.
What is HMO
PPO members pay higher monthly premiums so they can go to in-network providers and out-of-network providers for the same cost.
What is False
This type of plan does not need a valid enrollment period for disenrolling or enrolling into another plan.
What is Medicare Supplement
This part of Original Medicare usually comes with a $0 premium for most individuals.
What is medicare part A
Physician services, X-rays, Preventative services, and Durable medical equipment are covered under original Medicare part:
What is medicare part B
Inpatient hospital services, Skilled Nursing Facilities, Emergency room services, and Hospice care fall under medicare part A. Which of these does not belong?
What is Emergency room services
Name one rating factor for Stars and Cahps
Staying healthy, managing chronic conditions, member's experience with the plan, member's complains and changes in the plan's performance.
Original Medicare does NOT cover:
What is: prescription drugs, Routine dental services, routine eye exams, hearing aids, healthcare while traveling outside of the U.S, Chiropractic care, Part A and B deductibles/copays
These plans help pay some out-of-pocket costs not covered by Original Medicare Parts A and B. These plans do not include prescription drug coverage
What is Medicare Supplement/ Medigap
The welcome to medicare visit is covered ____
Within the first 12 months of becoming eligible for Medicare part B.
EGWP stands for:
What is Employer Group Waiver Plans
Members enrolling into a ___ plan must select a Primary care physician at the time of enrollment or one will be appointed to them.
What is HMO
Name one type of PCP
Geriatrician, Family Physician, General Practitioner, Internal medicine, Pediatrician
If a member is termed where in Sapphire can we see the term reason?
The "eligibility tab"
Name two eligibility requirements for enrolling into a Florida blue part D plan
Living in the plan service area and being eligible for original Medicare parts a or b.
This is Florida Blue's dual-eligible special needs medicare plan.
What is Florida Blue Medicare complete HMO