Learning Lab

Medigap

100

This is the timeframe when the beneficiary is eligible for any supplement offered in their area

                        OEP

200

This is the timeframe when the beneficiary can purchase certain supplement plans without underwriting

                 Guaranteed Issue

300

This supplement covers 100% of all Medicare cost sharing including deductibles and coinsurance

                     Plan F

400

This Medigap plan requires underwriting and $20 copay for doctor visits and $50 copay for an emergency room visit

                      Plan N

500

This is required of the beneficiary to answer medical question for approval

              Underwriting

PDP

100

This is the first stage of PDP coverage and must be paid before the plan will cover beneficiary prescription cost

                    Deductible

200

This stage occurs after the deductible is met

               Initial Coverage

300

This is the list of covered medicines determined by the carrier

Formulary

400

This happens when a beneficiary without creditable coverage does not sign up for a PDP plan when eligible

           Late Enrollment Penalty

500

This stage occurs when your total prescription drug cost reaches $4130

Donut Hole (Coverage Gap)

Part B

100

$148.50

What is the 2021 Part B premium

200

$203

What is the Part B deductible

300

This is the coinsurance percentage amount the beneficiary is responsible for

 20%

400

This is the additional premium required for high income earners

 IRMAA

500

This is the timeframe when they can sign up for Part B if they don't enroll when they become eligible

General Enrollment Period (GEP)

Creditable Coverage

100

This coverage is offered to Native Americans

Indian Health Services

200

This coverage is for military personnel and does not coordinate with Medicare

VA

300

This beneficiary has a $6000 deductible

Employer Group Health Plan (EGHP)

400

This coverage may require employment thru the government

Federal Employee Health Benefit

500

GoHealth does not offer plans to beneficiaries with this type of creditable coverage

Tricare and or Champ VA

Part C

100

This plan is offered to beneficiaries who have both Medicare and Medicaid

DSNP (Dual Eligible Special Needs Plan)

200

This type of plan is for beneficiaries with specific health conditions

CSNP (Chronic Special Needs Plan)

300

This type of plan requires the beneficiary to have a primary care physician

HMO

400

This document is used to quote plan benefits

Summary of Benefits (SOB)

500

This type of MA plan allows the beneficiary to choose a stand alone drug plan 

PFFS