Medicare 101
Part A and B of original medicare covers
What is Hospital and Medical
LIS is defined as
What is A federal program that helps medicare beneficiaries pay for prescription drugs
Medicaid is defined as
What is a state program that helps with medical costs for some people with limited income and resources
This carrier covers lenses for glasses at no cost
What is United Health Care
Two questions to ask if beneficiary doesn't know doctors name
what is do you have a prescription bottle with the doctors name on it/ What is the name of the facility the physician works at
Part C is defined as
What is Part A and B through private insurance company, includes drug coverage and can offer additional benefites not covered by Original Medicare like dental, vision and hearing
The benefits of LIS (4)
What is lowers the cost of prescriptions, lowers part D deductible, Lowers MAPD/PDP premiums, eliminates any Part D late enrollment penalty
This is needed to run a medicaid report
What is Name, DOB and Zipcode
This carrier offers essential extras (and 2 big things you can use it for)
What is Anthem. What is food and utilities
What tool(s) do we use to look up a beneficiary's medicaid information
What is Jarvis and humana
Part C eligibility
What is has both part A&B, must live in the plans service area, must continue to pay part B premium, must pay plan premium (if applicable)
The 3 stages of Part D
What is Stage 1; Deductible, Stage 2: Initial coverage, Stage 3: Catastrophic coverage
The benefits of Medicaid
What is pays Part B premium, DSNP eligible for qualifying levels, Cost share protection for those with full medicaid
The benefits of Humana DSNP OTC benefit
What is the benefit rolls over month to month.
These carriers require a legacy application
What is Humana, Zing, Aetna and Devoted
The main differences between an HMO and PPO network
What is HMO plans must have a primary care doctor, must get referrals for specialists, cannot receive coverage OON
These four things must be verified for all meds
What is Name, Strength, Form and Quantity
Levels of medicaid that are cost-share protected vs non-cost share protected
(NON CSP) QI, SLMB, MSP, QDWI
This Carrier offers coverage for implants
What is Anthem
Other than workday, the first thing you log into when arriving
What is five9
4 differences between Medigap and Medicare Advantage plans
What is Medigap plans have higher premiums and no copays, freedom to choose doctors, does not cover routine services, covered anywhere in US
MA plans have low premiums with copays, could have restricted network, may need referrals, may include extra benefits
These are the two most common memory medications
What is Donepezil and Memantine
Signs a D-SNP plan takes partial Medicaid
What is sliding scale for copays/coinsurances for hospital/medical
This Carrier allows you to use your otc benefit at Sams Club, Costco, and Uber Eats
What is United Healthcare
These 7 things should be included in broker notes
What is Doctors, meds, preferred hospital and pharmacy, Current plan and pitched plan, MBI/A&B start dates, Needs of clients, Transfer/enrollment code