Acronym Salad
What you pay
EOC Benefit Categories
Election Periods
Mystery Bag!
Membership Accounting
100

EOC

What is evidence of coverage

100

A set amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or a prescription drug.  

What is a Copayment

100

The correct benefit category for a pre-op physical

What is Physician/Practitioner services, including doctor's office visits 

100

This is the period of time when you can enroll when you are first eligible for Medicare,

What is the initial enrollment period, 7 months. 3 months prior to 65th bday month and 3 months after.

100

The delegated business that helps member's get the ball rolling to see if they qualify for LICS/LIS. 

What is My Advocate (Change Healthcare)

100

These are all the ways a member can pay their premiums currently.

What are mail, EFT, online, phone, bill pay through bank, SSA deduct (PWO) 

200

TAT

What is Turn Around Time

200

An amount you may be required to pay as part of your cost sharing for certain benefits. Usually a percentage. 

What is Coinsurance

200

The correct benefit category for knee replacement surgery

What is inpatient Hospital Services or Outpatient Surgery


200

October 15th to December 7th Every year

When is the Annual Election Period?

200

All the plans the member has the option to add a dental rider for additional dental coverage. 

What is Essentials Rx, Standard, Value Plus, EssentiaCare Secure, EssentiaCare Grand, Classic

200

This is the 2024 premium for the Essentials Rx North plan. 

What is $56?

300

ANOC

What is Annual Notice of Change

300

The periodic payment to Medicare, an insurance company, or a health care plan for health and/or prescription drug coverage

What is a premium

300

The correct benefit category for a thyroid test

What is diagnostic tests, X-rays, and clinical laboratory services 

300

When circumstances in a member's life creates a need to make changes to their plan outside of the Annual election period.

What is a special election period?

300

This is the name of the computerized voice for Warm Health

What is Mary Beth

300

This is a letter that indicates the member's premium dollar amount. They can be sent for previous and current dollar amounts.

What is the premium verification letter

400

IRMAA

What is Income Related Monthly Adjusted Amount

400

The most that you pay during the calendar year for in-network covered Part A and Part B services. Amounts you pay for your plan premiums, Medicare Part A and Part B premiums, and prescription drugs do not count toward this.

Maximum Out of Pocket Amount

400

The correct benefit category for a continuous glucose monitor

What is diabetes self-management training, diabetic services and supplies 

400

This type of plan does not have strict open enrollment dates.

What is a group plan?

400

This is what UCare Medicare plans used to be called.

What is UCare for Seniors (UFS)

400

The wording in the text box at the top of this letter is: 

We need your help to complete your application.

What is the Missing Information Letter?

500

PAC

What is the provider assistance center

500

The amount the member must pay for health care or prescriptions before their UCare plan begins to pay.

What is the deductible

500

The correct benefit category for a 3D mammogram

What is outpatient diagnostic test and therapeutic services and supplies and Breast Cancer Screening


500

This is the period of time each year when individuals are allowed a one-time change to their plan outside of the AEP. 


What is the Medicare Advantage Open Enrollment Period (MAOEP). Jan 1-March 31

500

This is the name of the services for root canal therapy on permanent teeth, including pulpotomies, indirect pulp-cap, and root canal retreatment 

What is Endodontic services 

500

The cost a member pays in 2024 to Medicare for their part B premium. 

What is $174.70