Humana
What year was Humana founded?
1961
A federal health insurance program that pays for hospital and medical care for elderly and Indvidual's with certain disabilities or medical conditions.
Medicare
Bradley initial enrollment period has expired. He Never enrolled in a Part D plan because he had creditable coverage with his employers COBRA plan
LEC
These plans do not require you to choose a primary care physician (PCP) and do not require referrals. For example, if you already have a doctor you like, you can continue receiving care from that provider.
PPO Preferred Provider Organization
85%-100%
The passing score for Quality
Caring, curious and committed are important to Humana because they are Humana's what?
Humana's core values
You may be eligible for this if you are
65 and older
A child under age 19
Pregnant
Living with a disability
A parent or adult caring for a child
An adult with dependent children
An eligible immigrant
Medicaid
This SEP is for individuals enrolled in a PDP or MAPD may disenroll to enroll or maintain other creditable drug (such as TriCare or VA coverage) by using this SEP to enroll in a MA-only plan. The effective date of enrollment is the first day of the month following the month the enrollment request is received by the organization.
OCC
Value added services are not offered on the Humana Achieve Plan
Sliver Sneakers
How much is this Complient component worth?
C17 - Did agent refrain from claiming to be endorse or work for Medicare
8 POINTS
In what states does Humana offer 5Star plans?
FL, NC, KY, LA, TN, MS, OR
Each state sets their own guild lines services and legibility.
Medicaid
Allows member who received notification that Medicaid level would change to enroll into a new plan within two months of notification.
MCD
Centerwell, Oak Street, Conviva, Jencare, Dedicated Senior Care, Optum, Heal
JOA
What are the two mandatory statements that need to be mentioned to a member on an HRA?
"You may stop this survey or decline to answer any of the questions at any time if you feel uncomfortable."
"As your agent I may receive compensation for helping you to complete this survey."
Who is the current CEO of Humana
Bruce Broussard
Chief Executive Officer
How many states does Humana offer DSNP in?
34
Valid intuitions and facilities for the SEP OEP-I
Skilled nursing facility, nursing homes, intermediate care facilities for mentally disabled, long term care hospital, psychiatric hospital and rehabilitation hospital.
This plan pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
Plan N Med Sup
☐ Review coverage for out of network providers and services
☐ Coverage outside the US
☐ Dental, Vision, and Hearing
☐ Right to cancel and date
☐ Ask to review any other benefits of interest
☐ Accurately answer all questions
Are all a part of what compliance category?
C10 (Summary Of Benefits)
Effective January 1, 2024 coverage will be available for the following preferred continuous glucose monitors
Dexcom & Freestyle Libre
What are the states that Humana offer Medicaid only plans (healthy Horizons)?
FL, IA, KY, LA, OH, OK, SC
Mr. Torres is 68 yrs old. Delayed his part B at age 65 because he was still working but re-enrolled in a Part D plan at that time.
ICEP
The trial Right Period is 3 years in this state
Maine
MA organizations holding or participating in marketing events may not conduct activities, including health screenings, health surveys, or other activities that are used for or could be viewed as being used to target a subset of members.
Cherry Picking