Starting Medicare
What is the name of the government agency that most people contact to sign up for Medicare?
Social Security Administration (SSA)
True or False: Part A has a $0 premium for everyone.
False: Prospects may experience a Part A premium if they did not pay enough in Medicare taxes while they/their spouse were working.
What is an out-of-pocket limit on a Medicare Advantage plan?
The amount/limit you must hit before the plan pays 100% of your covered health services for the rest of the calendar year.
True or False: All Medicare Advantage plans include coverage for prescriptions.
False – There are some MA-only plans that don’t include drug coverage.
True or False: Medicare Supplement plans include coverage for prescriptions.
False
True or False: If you apply to start getting retirement benefits from Social Security (or the Railroad Retirement Board) at least 4 months before you turn 65, you’ll automatically get Part A (Hospital Insurance) and Part B (Medical Insurance) when you turn 65.
True
We frequently work with Medicare Parts A, B, C, and D. What is Medicare Part C?
Medicare Advantage Plans
_______ refers to a period of time when a person can elect to change their coverage outside of the annual election period.
Special Enrollment Period (SEP)
What would qualify someone to enroll in a Medicare Advantage Plan?
Parts A+B and have a valid election period
A nickname for Medicare Supplement plans is _______.
Medigap
True or False: If you sign up for Medicare today, you’ll receive a welcome package with a Medicare card. On this card, you’ll see a Medicare number, Social Security number, and your effective dates for Parts A and B.
False – Social Security numbers are no longer displayed on Medicare cards to prevent identity theft.
True or False: Part B includes coverage for outpatient mental health care
True
“HMO” stands for Health Maintenance Organization. What does “PPO” stand for?
Preferred Provider Organization
Many, but not all, Medicare Advantage plans require beneficiaries to see a primary care doctor and obtain a _______ before they can see a specialist.
Referral
You do not need a special election period to enroll in a Medicare Supplement plan. However, having a _______ scenario can keep you from going through underwriting.
Guaranteed Issue
You can qualify for Medicare when you are 65. How could someone qualify for Medicare if they are under 65? (Be specific)
If you’re getting Social Security disability benefits, you’ll get Medicare automatically after getting disability benefits for 24 months.
What is the Part B premium for 2025?
$185/month
Your uncle is searching for a list of covered drugs on a Part D plan. What is the name of this list?
Formulary
How many types of Medicare Advantage plans are there?
5 (HMO/PPO/SNP/MSA/PFFS)
Federal law doesn’t require companies to sell Medigap policies to people ______.
Under 65
What disease would allow a prospect to get Medicare automatically as soon as they start getting disability benefits?
ALS (also called Lou Gehrig’s disease)
If you don’t sign up for Medicare, you may experience a penalty. What Part(s) of Medicare could someone experience a penalty on?
Parts A, B, and D
The extra amount added to your Part D premium due to having a higher income is called _________.
(IRMAA) Income Related Monthly Adjustment Amount
Medicare Advantage Plans have their own special election period that runs from January-March. What is the name of this SEP?
(MA-OEP) Medicare Advantage Open Enrollment Period
Starting January 1, 2020, Medigap plans sold to new people with Medicare weren’t allowed to cover _______. Because of this, Plans C and F are no longer available to people new to Medicare starting on or after January 1, 2020.
the Part B deductible