Medicare FAQs
When is the Annual Enrollment Period?
October 15, 2026 to December 7, 2026
Medicare Advantage plans must cover at least the same services as these two parts.
What are Medicare Part A and Part B?
Pt wants a Refund, what are the correct next steps by PRM.
Send email to RCM
Ms. Lisa met with the PRM before going back with the provider. As she's checking out her PRM asks her to meet her in the PRM office to follow up before leaving
What is PRM sandwhich
This enrollment period allows Medicare Advantage members to switch plans Jan 1 – Mar 31
What is OEP (Open Enrollment Period)?
This part of Medicare provides coverage for prescription drugs
Part D
Who handles statement or billing explanations
both billing team and PRM
Sheet handed to Welcome coordinators at the Service Team morning huddle.
What is Catchlist
Each plan has a list of covered brand-name and generic drugs called a
Formularies
These plans do not allow you to leave the provider network
What is an HMO plan?
Itemized Bill request (Send a Detail Bill)
Send email to RCM requesting an itemized bill
A process that lets patients with Medicare Primary designate Oak Street Health as their primary clinician or main source of care
What is Voluntary Alignment
A life event like moving or losing coverage triggers this type of enrollment
What is a Special Enrollment Period (SEP)?
The yearly cap on what you pay out-of-pocket
What is the MOOP (Maximum Out-Of-Pocket)?
Pt is upset and wants to speak to billing
this is a great opportunity for the PRM to educate the patient and help with service recovery!
The Practice Manager (or delegate) should have a private conversation with the patient or family member informing them that their behavior is not acceptable at Oak Street Health.
Behavioral Contract