SEP
What do you do if it shows in Sunfire and Marx that they have no enrollments?
Ask how they pay for their drugs
When making bullet points what side is their current coverage on?
LEFT
If you have LIS do you automatically get Medicaid?
True or False
False
When is AEP?
Oct 15th- Dec 7th
What states do not have D-SNP's?
Illinois, Massachusetts, Oregon, Idaho.
When you can't find an SEP what do you do?
Ask about their Income and see if they qualify for LIS
What is covered under comprehensive Dental services? NAME THREE EXAMPLES
Fillings, Extractions, Root Canals, Crowns, Dentures.
$1.55-$4.60
What two periods follow the 3-1-3 rule?
IEP and IEP-2
What does E.E. stand for?
Essential Extras (or everyday extras)
What are the SEP's that can only be used once a year?
5-star, SPAP, LEC
Name the 6 Additional benefits in the bullet points. In the order you would write them.
Hearing, Dental, Vision, Transportation, OTC, Fitness.
If a client has Medicaid, What percent of LIS coverage will they have?
100%
How many time(s) can you change your plan using OEP?
Once
What does this describe..
High monthly premium with little to no copays
Medicare Supplement
What is the Sunfire code for FEMA?
DST
What are the first 7 bullet points? In the order you would write them.
Monthly Plan Premium, Part B Premium Reduction, MOOP, Inpatient Hospital Copay, Outpatient Hospital Copay, Primary Care Copay, Specialist Copay.
22,800$
Albert calls wanting to switch his plan in November and he has LIS and it has not been used this quarter, Can you use LIS as a valid SEP?
No because its Quarter 4.
How can you tell a client has Medicare Advantage in the MARX CHECK?
The plan will start with an "H" or an "R"
You are trying to put Eileen on a Aetna plan and OEP has been used. Can you use FEMA as an alternate SEP? (It would be the last resort option)
No
What are we looking for in the SOB when it says outpatient hospital?
Surgery
What is one perk that you get with LIS that regular Part D coverage counts as a penalty?
You do not get a late enrollment penalty with LIS.
Norma Jean calls you about transferring out of her Medicare Plan and it is within OEP season. What other question must be answered to make sure she qualifies for OEP?
Does she have a Medicare advantage plan or OG Medicare? IF SHE HAS OG MEDICARE SHE DOES NOT QUALIFY
How many days once you turn 65 do you have to enroll for PART D coverage without penalty?
63 days