SEP CODES
If a Medicare Advantage plan member moves does this qualify them for a SEP , If so how long do they have to use this SEP .
you have a 2-month SEP to enroll in a new plan offered in your new residence area. This SEP begins either the date of your permanent move or the date you notify your plan of your move, whichever is later.
What is is Medicare Part A also known as ?
Hospital Insurance
What is a Medicare Advantage Plan also known as?
Medicare Part C , MAPD
What is the extra amount an individual may have to pay if they did not enroll into a Part D plan when they first became eligible?
Late Enrollment Penalty
What is the name for a secondary insurance plan that picks up where Medicare ends?
Medicare Supplement Insurance (Medigap)
Just found out I am losing creditable drug coverage the last day of the month. do I qualify for a SEP if so how long do I have to use this SEP
Yes, you have up to 2 months after losing coverage
What is not covered by Medicare Part A
Medicare Preventive Services.
What additional services which Medicare does not cover that might be covered under and Adavantage Plan?
Dental, Hearing, and Vision
What is the amount that an individual must pay before their Part D plan starts paying on the medication?
A Deductible
When could a person opt out of a Medicare Part D plan?
If they have creditable drug coverage
I have both Medicare and Medicaid and I just enrolled into a Dual plan effective the 1st of Feb. But I want a to enroll in your companies Dual plan . Can you help
you can switch your plan once per quarter from January 1 through September 30, and during the Medicare Annual Enrollment Period from October 15 through December 7 each year.
What is the normal Part B monthly Premium for 2024
$174.70
What does a Medicare advantage plan cover?
Medicare Advantage Plans provide all of your Part A and Part B benefits, including new benefits that come from laws or Medicare policy decisions. Plans must cover all emergency and urgent care (both physical and mental), and almost all medically necessary services Original Medicare covers.
What is the drug phase a Medicare member falls into after the initial coverage limit is met in the drug plan
Donut Hole or Coverage Gap
Which part of Medicare would cover Durable Medical Supplies?
Medicare covers some supplies as durable medical equipment.
I just enrolled into a plan last month but now I am moving into a LTC facility and my insurance wont work in the facility I am moving into is it to late to switch plans
No , SEP is continuous monthly SEP due to living in a long term care Facility
What is the period of time called that runs from 3 months prior to the month you turn 65 to 3 months after the month you turn 65?
IEP, Initial Enrollment Period
What part of Medicare must an individual have in order to have a Medicare Advantage Plan?
Medicare Part A and Part B
What is the name of the list of medications that a Part D plan covers?
Formulary
What is the normal age that a person would be eligible for Medicare?
Age 65
Who is eligible for a Part D 5 star plan ? and when is the 5 star SEP used
Medicare members are eligible even if they don't have a PDP/MA-PD now ( SEP 5 Star can be use Dec.8th-Nov.30 of the following year)
What is the amount Medicare Part B normally pays for a Medicare approved service.
After you've paid your Medicare Part B deductible for the year, Part B generally pays for 80% of covered medically necessary services. You're responsible for a 20% Part B coinsurance for most covered services.
When is the Annual, Open Enrollment Period for a Medicare Advantage Plan?
January 1 – March 31 each year.
Normally a person may change their Part D plan only during?
Oct.15-Dec.7th , AEP
What is the form a Medicare beneficiary receives quarterly showing what claims Medicare has paid?
Medicare Summary Notice (MSN)The MSN is a notice that people with Original Medicare get in the mail every 3 months. It shows: All your Part A and Part B-covered services or supplies billed to Medicare during a 3-month period. What Medicare paid.