Original Medicare
Supplements
Medicare Advantage
Enrollment Periods
Part D
100

What part of Medicare covers inpatient hospital care, skilled nursing facility care, and hospice?

Bonus: What does a client pay for Day 1-60 of a hospital stay?

Part A

Bonus: $1632

100

What parts of Medicare does a client have to be eligible for to purchase a supplement?

Bonus: A Medicare supplement may also be called this?

Part A AND Part B

Bonus: Medigab

100

Medicare Advantage is also known as?

Bonus: Advertised as "free" but the client still pays what?

Part C or MA Plans

Bonus: Part B monthly premium

100

When is Medicare Annual Enrollment Period (AEP)?

Bonus: If a client enrolls in a new plan during AEP, when is their effective date?

October 15th-December 7th

Bonus: January 1st

100

Part D covers what?

Part D may also be called this.

Prescription Drugs

Bonus: PDP

200

What part of Medicare covers services from doctors, outpatient care, durable medical equipment, and preventative care.

Bonus: What is the cap for the client's 20% coinsurance?

Part B

Bonus: There is NO cap!

200

What does a supplement cover?

Bonus: What does a supplement NOT cover?

Part A and B coinsurance (amount depends on the plan type)

Bonus: Long term care, dental, hearing, vision, and prescriptions.

200

The set amount the client must pay for covered services before the health plan begins paying for those services is called?

Bonus: The percentage of the cost of services the client must pay is called?


Deductible

Bonus: Coinsurance

200

Seven month period, including the three months before, the month of, and the three months following the client's 65th birthday.

Bonus: If a client's birthday is 7/10/1959 and you enroll them May 1st, what is their effective date?

Initial Enrollment Period (IEP)

Bonus: 7/1/2024

200

What are the 6 drug tiers?

Bonus: If a plan has an annual deductible, which Tiers will it apply to?

Preferred Generic, Generic, Preferred Brand, Brand, Specialty, Select Care

Bonus: Tier 3, 4, and 5

300

Who gets Part A and B automatically?

Bonus: When does it begin if your birthday is on the first of the month?

1. Receiving SSI or RR retirement
2. On disability for 2 years
3. ALS

Bonus: 1st of the month prior to birth month

300

What supplement plans are no longer available? 

Bonus: When did these plans become unavailable?

Plan C and Plan F

Bonus: after 1/1/2020

300

Most MA plans include these benefits.

Bonus: What is the benefit of having a maximum out of pocket (MOOP)?

Drug coverage, dental, vision, hearing, and flexible extras.

Bonus: Once a client has paid the MOOP, the health plan pays 100% of covered services for the remainder of the year.

300

One time election from January 1st to March 31st

Bonus: Who can make a change during this time, and what change can they make?

MA Open Enrollment Period (OEP)

Bonus: Clients enrolled in MA plans can change MA plans or return to Original Medicare and join a PDP.

300

Actual drug cost will vary depending on?

Bonus: What is a formulary?

Formulary, Tier, benefit phase, pharmacy, LIS status

Bonus: A list of prescription drugs covered by the plan

400

Who pays a $0 premium for Part A?

Bonus: What is the cost for Part A if a client or their spouse have not worked 40 quarters?

Client or their spouse who worked 40 quarters.

Bonus: $278 or $505 monthly.

400

What plan is the most popular?

Bonus: What does this plan NOT cover?

Plan G

Bonus: Part B annual deductible

400

Types of MA Plans?

Bonus: Why would you NOT recommend a HMO plan, assuming it had the best benefits and the client's doctors are in network?

HMO, HMO-POS, PPO, PFFS, MSA

Bonus: If the client travels regularly.

400

Able to make a change once per quarter during the first nine months of the year

Bonus: If you change a client's dual plan on 4/10/2024, what will the effective date be?

Dual Eligible/LIS Eligible

Bonus: 5/1/2024

400

What are the first two drug plan stages?

Bonus: What is the maximum Part D deductible?

Deductible and Initial Coverage

Bonus: $545

500

What is the typical cost for Part B?

Bonus: How can a client pay for Part B?

$174.70 monthly

Bonus: SS deduction, quarterly bill, bank draft, online through their Medicare account.

500

What plan is the second most popular?

Bonus: What does this plan NOT cover?

Plan N

Bonus: Part B annual deductible and Part B excess charge

500

What are the types of Special Needs Plans (SNP)?

Bonus: What conditions would make someone eligible for CSNP?

CSNP, DSNP, and ISNP

Bonus: Diabetes, ESRD, HIV/AIDS, chronic heart failure, dementia, and cancer

500

Outside of OEP, IEP, and AEP, what opportunities should you look for to enroll a client who is not eligible for Medicaid or LIS?

Bonus: When can a Five Star Plan SEP be used?

5 star plan, moved, disaster

Bonus: Once from December 8th to November 30th

500

What are the last two drug plan stages?

Bonus: What is the total amount a client spends inside the donut hole?

Coverage Gap (Donut Hole) and Catastrophic

Bonus: $8000