Original Medicare
Advantage Plans
Supplement /Medigap Plans
Prescription Plans
Election Periods
100

Does Original Medicare typically cover prescription Drugs?

No

100

Medicare Advantage is also known as?


Medicare Part C

100

Do members need Part A and Part B to sign up for a supplement plan?

Yes

100

What four things do you need to sign up for a part D drug plan?

 Part A OR Part B, Live in the plans service area, Have a current enrollment period

100

What enrollment period gives the beneficiary a 7-month window to enroll?


IEP (Initial Enrollment Period)

200

What are the two parts of Original Medicare?

Hospital (Part A) and Medical (Part B)

200

What parts of Medicare does a Medicare Advantage Plan usually cover?

 A, B, and D

200

Do Medigap plans come with dental, or vision coverage?

No, while you can get discounts, it doesn’t come with coverage.

200

What is a Medicare program that helps with Drug costs and premiums?

 Extra Help (LIS)

200

If a member has multiple enrollment periods how would you know which one to use?  

Use the Enrollment Period Hierarchy

300

How long do members need to be on disability to be eligible for Medicare?

24 Months (2 Years)

300

What 4 things do you need to be eligible for a Medicare Advantage plan?

 Part A, Part B, Live in the plans service area, Have a current enrollment period

300

When is the best time to sign up for a medigap plan?

During their Open Enrollment Period (6 month time frame from Medicare effective date)

300

I have a Supplemental Plan G, can I get a PDP with that? 


Yes, Medicare Supplement plans do NOT include prescription coverage so you will need one.

300

When Does the Annual Enrollment Period (AEP) occur?  

Every year from October 15th – December 7th

400

What 4 things Does Part A cover?

Hospital Care

Skilled Nursing Facility Care (SNF)

Home Health Services

Hospice

400

What are four major types of Medicare Advantage plans?  

HMOs, PPOs, POSs, and SNPs

400

If you sign up for a supplement plan what else do you need to sign up for in order to not get a penalty through Medicare?

Part D, Drug coverage

400

Are there any limiting health factors of Prescription Drug Plans in order to get one?



No, No underwriting or health questions.

400

What is the enrollment period Hierarchy in order. 

Initial Enrollment Period (IEP/ICEP)

Special Enrollment Period (SEP)

Annual Enrollment Period (AEP)

Open Enrollment Period Institutionalized (OEPI)

500

What 5 things does Part B cover? 

Doctor Visits, 

Outpatient medical services, 

Emergency room services (outpatient)

Mental health care

Laboratory services

500

If a member is dual eligible what does that mean? 


They have both Medicare and Medicaid. Eligible for a SNP plan if one is in their area.

500

What would most likely happen if someone signs up for a medigap plan outside of their Open Enrollment period.

 They would have to go through a Health assessment (AKA Underwriting)

500

When would your coverage begin if you signed up for a PDP during AEP?

January 1st of the next year

500

Name 4 of the most common Special enrollment periods. 

Moving, Change to Medicaid, Change to Extra Help (LIS), Losing Employer Group Health Coverage  

 

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