Plan Benefits
What is the deductible for the Saver and Secure plan in 2024?
$545
LEP
Late Enrollment Penalty
Offer the standard, basic, Medicare benefits.
Secure RX
True or False
AEP is from October 16 to December 7 of each year.
False.
AEP is from October 15 to December 7 of each year.
Current day is June 30, 2023 and Mr. Tim Bradford will turn 65 on Sept. 25, 2023. What will be his Initial Enrollment Period?
Three months before the month of 65th birthday , and three months after.
What is a premium payment?
Amount paid for insurance coverage
What is the meaning of CMS?
Centers for Medicare and Medicaid Services
Preferred mail order Pharmacy?
Express Scripts.
They can process a telephonic enrollment with the customer.
Telesales Agents
Can Alex enroll in a Cigna Medicare plan now that he has just retired from his employer?
Yes, he has SEP.
How much is the initial coverage limit for 2024?
5030
What is the meaning of SPAP and ADAP?
ADAP - Aids Drug Assistance Program
SPAP - State Pharmaceutical Assistance Program
A good fit for someone needing a very high level of cost protection with a robust drug list.
Cigna Extra Rx
True or False
LEP (Late Enrollment Penalty) is a corresponding fee for members who had been without coverage for a continuous period of 60 days or more.
False.
LEP (Late Enrollment Penalty) is a corresponding fee for members who had been without coverage for a continuous period of 63 days or more.
Jane Smith will turn 65 on November 25, 2024, and she plans to enroll in a Part D plan on January 25, 2025. When will her Part D plan begin?
February 1, 2025.
What are the 4 benefit stages?
Deductible
Initial Coverage
Coverage Gap
Catastrophic Coverage
PBM stand for?
Pharmacy Benefit Manager
This is considered a plan that has very low premiums and co-pays, with no deductible for many generic medications.
Saver Rx
True or False.
Special Enrollment Periods (SEP) are “periods of time in which a Medicare beneficiary may enroll in or change a Medicare Part D plan outside of the usual initial or annual enrollment periods due to very limited circumstances”.
True.
What are the different enrollment periods for Medicare?
IEP (Initial Enrollment Period)
AEP (Annual Enrollment Period)
SEP (Special Enrollment Period)
What is the difference between copayment and coinsurance?
Copayment is a fixed amount
Coinsurance is a percentage of the cost.
IRMAA
Income Related Medicare Adjustment Amount
It was renamed as Assurance for 2025?
Secure RX.
Defined as “coverage that meets Medicare’s minimum standards since it is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.
Creditable Coverage
What election period should Amanda take to change her Cigna Part D plan now that she has Extra Help?
SEP (Special Enrollment Period)