Medicare 101
The abbreviation "CMS" stands for..
What is Centers for Medicare & Medicaid Services
Most people get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) during this period. It starts 3 months before you turn 65 and ends 3 months after you turn 65.
What is Initial Medicare Enrollment Period
True or False: Statements like "the best" or "highest ranked" are permissible when discussing health plans with prospects.
False
The Tufts Health Plan Medicare Preferred HMO plans have earned a 5-out-of-5 star rating from Medicare for how many years?
5 years
We are a growing plan, now being offered to residents of _____ County for 2021
What is Middlesex County
When we mention "Original Medicare", we are referring to what parts of Medicare?
What is Medicare Part A and Part B
If you miss your Initial Enrollment Period, you can sign up during this enrollment period (January 1–March 31), and your coverage will start July 1
What is the General Enrollment Period
What does the abbreviation HIPAA stand for?
What is the Health Insurance Portability and Accountability Act?
What 2 plans offer a $1,000 preventive and restorative dental benefit at no additional premium?
What is Basic Rx and Saver Rx plans
When using what type of pharmacy network are the Rx copays are $0 for Tier 1 and Tier 2 drugs?
What is the preferred pharmacy network
In order to avoid a _______, Medicare recipients must have no gap in credible drug coverage.
What is a Late Enrollment Penalty
Your client is outside of the OEP season and informs you that she was recently diagnosed with diabetes. She may be eligible for this type of enrollment period. (must be specific)
What is the C-SNP Special Enrollment Period
True or False: We are able to ask for phone numbers from customer's friends/ family that the customer recommends to us.
False
The $0 premium Saver Rx Plan offers a wellness allowance up to how much at what frequency?
$250 annually
We are a growing plan, with almost _______ providers added to our network over the last year.
1,000
Mr. Kyle's 65th birthday is September 1, 2020. If he signs up for Medicare in May, June, or July, his coverage will start on ______.
August 1, 2020
During this enrollment period and dates a client will be able to:
What is the Medicare Advantage Open Enrollment Period, January 1st - March 31st
This is an intentional deception or misrepresentation of fact that can result in unauthorized benefit or payment.
What is Fraud?
The $0 premium Saver Rx plan is rich with benefits including $50 per ______ toward OTC items.
quarter
Our _______ plan includes a robust embedded dental offering, up to $1,500.
What is the Preferred $0 HMO plan
In most cases clients that are getting benefits from Social Security or the ___________ for at least 4 months, the client will automatically get Part A and Part B starting the first day of the month they turn 65.
What is the Railroad Retirement Board (RRB).
On August 31st, Susan lost her group health plan coverage. _______ is her last day to enroll into a plan during this special enrollment period.
October 31st
This is an action that is improper, inappropriate, outside acceptable standards of professional conduct or medically unnecessary.
What is Abuse?
The $0 premium Saver Rx Plan offers how much for the embedded dental benefit?
$1,000
We are a not-for-profit, Medicare insurance company created by these two health care leaders:
What is Tufts Health Plan and Hartford HealthCare