Original Medicare
These two parts make up Original Medicare.
What is Part A and Part B
This part of Medicare provides Pharmacy coverage.
What is Part D?
With an HMO, members must elect _______.
What is a PCP?
The acronym for PPO is
What is Preferred Provider Organization
In order to be eligible for DSNP, a member must be....
What is Dually eligible (have Medicare and Medicaid)?
This is a 3 digit code that represents an individual Medicare Advantage plan.
What is the PBP number?
This part of Original Medicare has a monthly premium.
What is Part B?
Medicare Advantage plans replace Original Medicare and can be referred to as this.
What is also known as a replacement plan?
This plan is chosen by people who typically don't_____.
What is travel (or leave the service area)?
PPO members have in network coverage outside of Michigan as long as the provider......
What is Medicare Contracted
The DSNP plan is targeted to members with
These individual MA plans offer a monthly flex card allowance.
What are DSNP plans?
Original Medicare is managed by this entity.
CMS, Centers for Medicare and Medicaid Services
People with a Medicare Advantage plan cannot have ______.
What is any other coverage.
The acronym HMO stands for
What is Health Maintenance Organization?
Unlike HMO, PPO members don't have to.....
What is elect a PCP.
The acronym DSNP stands for
Dual Special Needs Plan
To locate an EGWP plan, this code will be needed from Pega to locate the correct EOC.
What is the sub-group number?
Once a member nears end of life or is terminally ill, and elects this, Original Medicare is responsible to pay.
What is Hospice?
Medicare Advantage plans may include _____, but may not.
What is prescription drug coverage?
Which two services are covered anywhere an HMO member goes?
What is urgent care and emergency.
PPO plans are typically chosen by people who like to.....
What is travel.
DSNP members are assigned two people upon enrollment...
What is a Nurse Care Manager and a HAA Health Navigator.
This plan has one open enrollment period!
What is Medicare Supplemental?
This enrollment period only comes once!
What is the initial enrollment period?
In order to enroll in a Medicare Advantage plan, people must have both _______ and ________!
What is Medicare Part A and Part B, also known as Original Medicare?
With an HMO, members utilize specialists in their ______.
What is their network?
PPO members are responsible for.......
What is Directing their own care.
DSNP enrollment periods are different than all other Medicare plans because.....
What is DSNP members are entitled to one SEP per quarters 1-3 and during quarter 4 they follow AEP.
These plans offer a standard and high option to their employees/retirees to choose from!
What are the FEHB / PSHB plans?