Medicare Basics
The number of Parts of Medicare
This plan must have a PCP
What is a HMO plan?
This benefit is managed by Access to Care
What is Transportation?
This is the main system that you will use to assist your member.
What is ASD?
Payments are due by this date and late after this date
What is the 1st and the 10th?
This is covered by Part A.
Hospital care; Skilled Nursing Facility; Hospice and Home health services
This is a plan purchased by the member
What is an Individual plan?
This benefit offers members access to over 13,000 gyms
What is Silver Sneakers?
This tab and subtab is where you can find all of the member's benefits.
What is Benefits and Benefit Details?
Payments are made here
What is PNC?
This makes you eligible to receive Medicare
What is 65, Certain Disabilities, or End Stage Renal Disease (ESRD)?
These are items and services that are not plan benefits, are not part of the Medicare Advantage Organizations plan's benefit package and may not be marketed to prospective enrollees, or used as an inducement or incentive for enrollment.
What are Value Added Services?
Bruce wanted to become Kaitlyn.
What is Gender Reassignment?
You would find the NGMENU in this system
What is Rumba?
Member can make a payment by.
Name ALL methods
What is Check, Money Order, Credit Card, Debit Card, Online, Telephone, EFT, SSPWH?
This is a private insurance company managed by Medicare
What is Aetna?
This network is limited to participating physicians and hospitals in New Jersey
What is The SNJ Prime Elite PPO?
These vaccines are included in the routine/preventive care benefit of a Medicare Advantage plan.
What is Pneumonia vaccine, Influenza vaccine, and Hepatitis B vaccine?
You would view a member's coupon book in this system
What is Trans Direct or Transamerican?
It takes PWH this long to be effective.
What is 1-3 months?
Member needs this to be able to have Aetna
What is Medicare Part A AND B?
This plan is only available for GROUP plans
What is ESA PPO?
A member can get a free Blood Glucose monitor from this company and by using this order code.
What is LifeScan and 123AET200?
This tab in ASD keeps track of all the benefits that a member has or has not used
What is Accumulators?
A member receives an invoice when.
What is when policy initially starts or when there is a balance due?