ELECTIONS
MEMBER WITH A MA/MAPD CAN CHANGE PLAN ONCE JAN1st-MARCH31st
OEP
T/F DISCLOSURES ARE REQUIRED ON ALL CALLS
False, disclosures are only on calls where you sale a plan.
WHO QUALIFIES FOR MEDICARE.
AGE 65 AND UP OR ON DISABILITY FOR 24 MONTHS
T/F MEDICAID IS A STATE AGENCY?
TRUE
WHAT IS THE ELECTION HIERARCHY?
IEP, OEP, SEP, AEP, OEP-I
CONDITIONS THAT WILL RESULT IN ENROLLMENT IN A CNSP
Diabetes, heart conditions, COPD, ESRD (chronic conditions).
T/F DOCTOR/RX LOOK UP IS OPTIONAL
False, you have to mention doctor/rx lookup on each call even if client declines rx input*
WHAT ARE THE FOUR PARTS OF MEDICARE?
A, B, C AND D
MCD IS USED FOR?
CHANGE IN MEDICAID STATUS
WHAT DOES TROOP STAND FOR?
TRUE OUT OF POCKET COST
MEMBER ENROLLS IN MA WHEN FIRST ELIGIBLE FOR MEDICARE
IEP
THIS DISCLOSURE IS REQUIRED TO CALLBACK A CLIENT
TCPA. “TO CONFIRM YOUR NUMBER IS ___. IF DISCONNECTED DO I HAVE YOUR PERMISSION TO CALL YOU BACK.”
WHAT IS THE MAXIMUM OUT OF POCKET (MOOP) for ORIGINAL MEDICARE?
THEY DONT HAVE ONE
WHAT IS THE HIGHEST LEVEL OF MEDICAID?
QMB
WHAT IS ORIGINAL MEDICARE PARTS?
A&B
MEMBER CAN CHANGE PLAN WITH QUALIFYING LIFE EVENT
THIS DISCLOSURE ALLOWS US TO LOOK UP CLIENT AND DISCUSS MA PLANS
SOA. “DO I HAVE YOUR PERMISSION TO LOOK YOU UP IN THE MEDICARE SYSTEM AND GO OVER PLANS WITH YOU?”
WHAT IS THE PART B PREMIUM FOR 2026?
$202.90
WHAT DOES SLMB STAND FOR?
Specified low income beneficiary
WHAT DOES MBI STAND FOR?
MEDICARE BENEFICIARY IDENTIFIER
RELEASE FROM INSTITUTION WITH IN 2 MONTHS
OEP-I
WHAT IS THE SCRIPT FOR TPMO?
WE DO NOT OFFER EVERY PLAN AVAILABLE IN YOUR AREA. CURRENTLY WE OFFER __ CARRIERS AND __ PLANS IN YOUR AREA. PLEASE CONTACT MEDICARE.GOV, 1800-MEDICARE OR CONTACT YOUR LOCAL STATE HEALTH INSURANCE PROGRAM (SHIP) TO GET MORE INFORMATION ON ALL OF YOUR OPTIONS.
WHAT IS THE PART A DEDUCTIBLE FOR 2026?
$1736
WHAT ARE THE FIVE LEVELS OF MEDICAID?
FBDE, QMB, SLMB, QI, QDWI
WHAT SYSTEM DO WE USE FOR ENROLLMENTS?
SUNFIRE