Drugs
A list of a plan’s covered drugs is referred to as a _______
Formulary
A list of a plan’s in-network doctors is referred to as a _______
Provider directory
Three common additional interests a caller may have include dental, vision, and _________.
Hearing
You’ve collected 6 medications from the prospect and ask if there are any more. The prospect says “Not really, just some vitamins.” Based on this response, what benefit might the prospect be interested in reviewing?
OTC benefit
If a prospect mentions having reduced copays on their prescriptions, they may have _____.
Additional assistance through programs like LIS/Medicaid
Aside from PCP’s and specialists, a best practice is to offer to look up any __________, ________, & ________ providers. (Hint: Benefits)
Dental, vision, hearing
______________ is a fitness program often offered as a benefit with medical coverage.
SilverSneakers/Renew Active program/Silver&Fit/OnePass
A prospect mentions having frequent doctors visits, and they want to pay a large upfront cost, so they don’t have to “nickle-and-dime” every time they use services. What would be the best recommendation for this prospect?
Medicare Supplement plan
A prospect only has 2 medications, a Tier 1 and a Tier 3. When reviewing the medication coverage on a plan, what required costs should be reviewed before asking for the sale?
Copays/coinsurances for all prescription tiers and any prescription deductible
Medigap plans will allow a prospect to see any provider who _________.
Accept Medicare
A portion of the Part B premium is covered by the insurance company. This is describing _____________.
Part B Giveback
The prospect mentions that they have a hard time getting around. What would be a good benefit to research for the prospect?
Transportation/In-Home Support/Companionship
The prospect tells you that they don’t need to review medications because they know that their copays are $15 and $75 dollars for their Tier 2 and Tier 3 medications on their current coverage. You can use this information to__________.
Look up the prospect’s medications on our plans and compare costs
Under Original Medicare, prospects will pay to meet the Part B deductible and then pay ______ of the Medicare-Approved Amount for most health care services.
20%
While Medicare Advantage plans generally do not offer worldwide coverage for routine healthcare, they may provide limited ________ and _________ care coverage outside the U.S.
Emergency / urgent
After presenting a plan, the prospect responds: “This is too overwhelming. I don’t know how my son does this all the time. I just don’t know what to say.” What would be an ideal follow-up question?
Ask if the son is POA/if they’d prefer to have someone there to assist in understanding the information prior to enrollment (friend/family/home visit)
A prospect mentions that they don’t have any medications and would like to enroll in an MA-only plan. The best next step would be to _________.
Verify they don’t have other forms of creditable drug coverage and explain that they could get a Part D penalty for not having drug coverage.
Asking how often a prospect sees their doctor is considered ________.
Cherry-picking/a compliance violation
Grocery allowances are an example of an SSBCI. SSBCI stand for ______.
Special Supplemental Benefits for the Chronically Ill
You’ve handled a lengthy call with a caller who says they love small talk and don’t get to talk to people very often. They mention feeling lonely and wishing their family and friends would visit them more often. What benefit may be of interest to them?
Companionship/Papa Pal/Adult day care centers