1. Insurance Basics
What card do you bring to the doctor?
Your insurance card.
What is the name of the period when you can change plans?
Open enrollment.
True or False: Medicaid is usually free or low-cost.
True
What is a copay?
A small amount you pay at the visit or pharmacy.
Where can you find the phone number to ask questions about your plan?
On the back of your insurance card.
What do you call the doctors and clinics your plan covers?
The network
How often does open enrollment happen?
Once a year.
Medicare Parts A and B cover hospital and ________ care.
Medical (doctor) care.
What do you call the amount your insurance pays?
A benefit or coverage.
If your doctor is not in your network, what might happen?
You may pay more or the plan may not cover it.
What is a prescription?
A medication ordered by your doctor.
True or False: During open enrollment you can pick a new plan even if nothing changed.
True.
What do you call a person who has BOTH Medicare and Medicaid?
Dual eligible.
What type of visit often has the lowest copay?
Primary care visit.
What should you bring to every appointment?
Insurance card, ID, meds list, questions.
True or False: All plans cover the same doctors.
False.
Name one thing to compare when choosing a plan.
Cost, copays, doctors, meds, network, services.
Medicare Part D covers what?
Prescription medications.
What do you call the full cost before insurance helps (not common in Medicaid)?
A deductible.
What should you do if you receive confusing insurance mail?
Ask a case manager or trusted person for help.
What is a “prior authorization” ?
When the insurance company must approve a treatment/med before you get it.
What is the monthly payment you might pay to keep a plan?
A premium.
What is the name of private plans that combine Medicare into one plan (A, B, D)?
Medicare Advantage (Part C).
Name one way to lower prescription costs.
Generics, preferred pharmacies, medication list, asking doctor for alternatives.
What is the document that explains how a plan works (copays, costs, rules)?
A: The Summary of Benefits.