Medicare AEP
This is Medicare's official name for the period from October 15 to December 7.
What is the Annual Election Period?
This is one of the most important things to update before the beneficiary chooses a Part D Plan.
What is the beneficiary's medication list, including dosages and frequency?
This is the meaning of PRN in a medical context.
What is "as needed"?
These are three common Part D utilization management restrictions.
What are prior authorization, step therapy, and quantity limits?
This is the program that provides assistance to low-income Medicare beneficiaries towards Part A and Part B premiums and cost sharing.
What is Qualified Medicare Beneficiary (QMB)?
The following statement is True or False.
"If I leave a Medicare Advantage Plan during AEP, I will have a guaranteed issue right to buy any Medigap Policy I want."
What is FALSE?
This statement is True or False.
"My drug is on the plan's formulary, so I know exactly what I will pay."
What is false?
This is the abbreviation meaning "twice a day".
What is BID?
This is the amount that an individual must pay before their Part D plan starts paying towards their medications.
What is the Annual Plan Deductible?
This type of plan is abbreviated D-SNP.
What is a Dual - Special Needs Plan?
During AEP, a beneficiary enrolled in Medicare Advantage has the option to make these 2 changes.
What is switch to another Medicare Advantage Plan, or disenroll from the Medicare Advantage Plan, return to Original Medicare, and enroll in a Part D plan?
These are the four things a counselor should have before conducting a Part D Plan Finder comparison.
What are:
1. Medication list (dosage, quantity, frequency)
2. Preferred pharmacies
3. Current plan name
4. Medicare/LIS/Medi-Cal status?
This is the abbreviation for hydrofluoroalkane in an albuteral inhaler.
What is Hfa?
This is the Part D coverage period applicable to beneficiaries who have reached the TROOP threshold?
What is Catastrophic Coverage?
This is abbreviated DME.
What is Durable Medical Equipment, a covered Part B benefit?
Most changes made during AEP become effective on this date.
What is January 1 of the following year?
A beneficiary takes five medications. The counselor finds a plan with the lowest premium. This is a better metric to consider.
What is the total annual cost (Estimated total drug + premium cost)?
Its medical abbreviation is HCL.
What is Hydrochloride?
This is the list of covered medications under a Part C/D plan.
What is the Formulary?
This is abbreviated ESRD.
What is End-Stage Renal disease?
These are the figures used to calculate the Medicare Part D Late Enrollment Penalty.
What are 1%, the national base beneficiary premium, and the number of uncovered months?
These are now offered for $35/mo and $50/mo respectively.
What are insulin and GLP-1 medications?
This is abbreviated DR on a medicine bottle.
What is delayed release?
This is a federal program that assists beneficiaries with their Part D related costs.
What is the Low Income Subsidy (LIS) or Extra Help?
This document is sent to Medicare Part C/D beneficiaries listing any changes in plan coverage, service area, or costs that will go into effect the following year.
What is the Annual Notice of Change?