MARx Key Indicators
SEP Dive
Medicare Medicaid
Useful Responses
New Benefits for 2022
100
When Reading a Marx the following would be key indications of how we should proceed with client.
What is we cannot touch due to them being enrolled in Medicare Limited Income Net Program which is a state assisted temporary coverage Medicaid Medicare program.
100
Define an SEP (DAILY DOUBLE)
What is a time period during which Medicare beneficiaries can change their Medicare Advantage or Part D coverage outside of the normal annual open enrollment period and after their initial enrollment period has ended
100
Does QDWI cover the part B premium?
What is no
100
Anytime you are asked a question prematurely
What is "That is a great question, and I'm going to get to that in just a moment, I promise you." (Pivot Back to call flow)
100
What is Anthem called in Florida?
What is Simply
200
Plans beginning with an 8 within the PBP number of a Marx can usually indicate that the plan might be
What is either an employer subsidy or retirement benefit plan
200
It is 07/06 and I have already used my IEP on 06/12 to enroll in a PDP, do I have an SEP? If so what is it?
What is no
200
I have QMB+ in Georgia and I move to Florida, do I keep my level 2 LIS?
What is yes
200
Are you Medicare/ are you a scam?
What is
We are contracted through major insurance companies such as Humana, CIGNA, Aetna, anthem, etc. to help you understand all the benefits that you are entitled to. Do you have Medicare part A&B?
We are the Medicare coverage helpline, who do I have the pleasure of speaking with. (pivot back to call flow).
You saw the Joe Namath commercial on TV, right! So, if we were a scam, we wouldn’t be on TV.
200
A program that offers discounts of up to 50% on health and wellness products and services, and it’s available to all Florida Blue members
What is Blue 365
300
What do you check under “election type code usage”?
What is if an election period was used and if the beneficiary has used their quarterly Lis
300
This SEP begins on the actual date of the release from incarceration or with the date the individual provides notification of such move and continues for two additional calendar months
What is INC
300
Define QMB vs QMB plus (DAILY DOUBLE)
What is Qualified Medicare Beneficiaries (QMBs) without other Medicaid , QMBs with full–benefit Medicaid
300
I’m not interested
What is
OH, Many people aren’t interested until they get a huge hospital bill, suffer a life changing medical event, or need medication due to a sudden diagnosis. An MAPD can placed MOOP limits on how much you pay, protect you from endless bills month after month, and provide prescription drug coverage! In addition to benefits such as dental, vision, hearing, silver sneakers, Acupuncture, OTC, transportation, many Plans can offer you $0 monthly premium!! How does that sound?
Ask questions about their current plan and situation. FIND THE PAIN POINT! And exploit it.
Well, why did you call us today? How can I help?
300
The difference between Wellness Bucks and Devoted Dollars (DAILY DOUBLE)
What is Wellness Bucks gives a reimbursement, Devoted Dollars are prepaid cards
400
Assuming there's an sep, a client calls in on 08/04 will full medicaid and there are no dsnps, based on the marx can we enroll them? If so in what? (DAILY DOUBLE)
What is yes, in a value plus if there is one or in the most suitable plan and check if they're cost share protected
400
I have Champ VA and I'm enrolled in an MAPD, do I have an SEP? If so what is it?
What is yes, OCC
400
Which levels of Medicaid cover the Part A premium (when applicable)?
What is QMB, QMB+, QDWI
400
Give an example of a negative sandwich
What is Great news, ... However.... BUT....Awesome news!! Lets get you enrolled!
400
What percentage of Cigna plans have dental benefits?
What is 99%
500
Special plans that only certain beneficiaries with certain special conditions qualify for. These plans also can be used with a standalone PDP, part D is not included.
What is 1876 Cost Plans
500
I lived in Europe for 2 years and I am moving back to the US to my same address, do I have an SEP? If so what is it?
What is yes, RUS
500
Income limits for QMB as of 2021
What is Individual $1,094, Married Couple $1,472
500
Is my shingles vaccine covered? (DAILY DOUBLE)
What is Its sometimes covered, if it is covered it is under part D. Some plans may require a copay. However, coverage (and cost) of the vaccine can vary depending on your chosen Medicare prescription drug plan, vaccine brand and the pharmacy where you have the vaccine administered.
500
I qualify for an Aetna DSNP and I am taking a tier 5 prescription, what is my copay?
What is 0