Basics
ICEP
Initial Coverage Election Period
OEP dates
January 1-March 31
Late Enrollment penalty
1% * X months * national average Premium (2019= $33.19)
What range of letters are associated with Medigap plans?
A-N
Who's job is Compliance
Everyone's Job
Part B Premium
$135.50
D-SNP
Dual Eligible SNP (Special Needs Plan)
4 phases
Deductible, Initial Coverage, Coverage Gap(donut hole), Catastrophic Coverage
Plans that aren't GI
G&N
What do you recieve for a Tier 2 offense?
Written Warning
5 things Part A covers
Hospice, Acute Hospital, Home Health Care, Blood, SNF
Companies we sell Part C for
Regence, Humana, Aetna
What counts towards TROOP
All Prescription cost YOU pay. Including Deductible.
Which Plan makes you pay up to $20 for Doctor co pays?
Plan N
What is a clear affirmative response?
YES or NO
$170.50
SNF days 21-100
Who is Part C provided by?
3rd party private insurance companies
$3820
The amount that gets you to the donut hole. Includes all prescription costs you and the Insurance company pay together.
What percentage is covered for foreign travel on Plan G
80%
You must say the privacy statement within?
2 minutes of first contact
Lifetime reserve day copay
$682
All Part C plans are all standardized the same way?
No that's Medigaps.
LIS Generic & Brand copays
Generic $3.40 Brand $8.50
Does Plan G limit out of pocket expenses?
No for the most part you won't have any out of pocket expenses.
What Percentage is passing?
90% score on each QA review
Anything below 80% is completely unacceptable