1
In 2027 how much is the new years Prescription Deductible
$700
All DSNPs will provide an OTC Wallet that transitions into an Extra Supports Wallet once and if __________ are met.
All DSNPs will provide an OTC Wallet that transitions into an Extra Supports Wallet once and if SSBCI eligibility requirements are met.
$2,400
what are the 3-prong SSBCI Eligibility Requirements
Have one or more chronic condition(s) that are medically complex and life-threatening, or that greatly limit overall health or ability to function; and
Are at high risk for going to the hospital or having other serious health problems; and
Require a high level of care coordination
What is LIS Level ?
Cost Share for Prescriptions – Members are designated LIS level 1, 2 or 3 which determines what the beneficiary will pay out of pocket for their prescriptions.
Members receiving 100% LIS premium benefit may still have a premium responsibility. 100% LIS benefit _______ refer to 100% of the member's plan premium being covered.
Members receiving 100% LIS premium benefit may still have a premium responsibility. 100% LIS benefit DOES NOT refer to 100% of the member's plan premium being covered.
Some plans will now use _______, while others will continue to use SafeRide and MTM Health. CSRs will need to review the EOC to determine which vendor a member must use for their transportation benefit.
Nations Transport
General Election New Jersey plans (not D-SNP or FIDE) offer a new ______ filed under Uniform Flex. The benefit offers ______ trips to and from dialysis appointments. Limited to 60 miles per one-way trip. Members must qualify for ______.
ESRD Unlimited Transportation Benefit
Unlimited Transportation
ESRD
who manages the Medicare GLP-1 Bridge Program
Medicare GLP-1 Bridge is a CMS-managed program
Cancer Care Support Program Important information is ______
Members cannot self-attest to this program
Members enrolled in a Contract-PBP that offers the program will be deemed eligible
Been diagnosed by a medical professional with some form of cancer
Are receiving active cancer treatment(s)
Have qualifying claims