Part A
This type of medical care is covered by Part A.
What are hospital stays, temporary stays in skilled nursing facilities, home health care, and hospice care.
This type of medical care is covered by Part B.
What are doctor's office visits, lab work, screenings, and outpatient hospital care.
Medicare Part C is also known by this name.
What is Medicare Advantage.
Before discussing plan details, agents must obtain this.
What is a Scope of Appointment (SOA)?
The place you go to check Humana plan placement
What is Humana Vantage
When you've worked at least 10 years and paid Medicare taxes.
What is premium-free Part A
This federally funded, state administered program can help lower/eliminate premiums and copays/coinsurance.
What is Medicaid.
These private companies, approved by Medicare, offer Part C plans.
What are Medicare-approved insurance carriers?
This disclaimer must be read at the beginning of every sales call.
What is the CMS-required disclaimer (“We do not offer every plan available…”)? (TPMO)
This is the number of days after submission when agents should verify if their application has placed.
What is 7 days (7-day rolling check)?
Part A covers up to these many days of inpatient hospital care with a set deductible.
What is 90 days (plus 60 lifetime reserve days)?
This monthly cost must usually be paid to keep Part B active.
What is the Part B premium?
Most Medicare Advantage plans include coverage for this, which Original Medicare does not.
What is prescription drug coverage (Part D)?
Failure to follow CMS telesales guidelines can result in this.
What is a compliance violation that may lead to disciplinary action, loss of contract, or CMS sanctions?
Part A provides coverage for this type of end-of-life care, either at home or in a facility.
What is hospice care?
The standard Part B coinsurance amount after meeting the deductible is this percentage.
What is 20%?
Many Part C plans offer extra benefits like dental, vision, or hearing. These benefits are called this.
What are supplemental benefits?
If a beneficiary asks about a plan you are not licensed or contracted to sell, you must do this.
Qualifying for Medicare and Medicaid at the same time.
This type of care is covered under Part A if it follows a 3-night inpatient hospital stay.
What is skilled nursing facility (SNF) care?
The percentage of the Medicare-approved cost of your health care services that you’re expected to pay after you’ve paid your deductibles.
What is coinsurance.
True or False: Medicare Advantage plans are the same across all states and counties.
What is False (plans vary by ZIP code and service area)?
During a telesales call, agents must provide this to the beneficiary before completing enrollment to ensure understanding of plan details.
What is a Summary of Benefits review (and required plan disclosures)?
Medicare Advantage plans have a yearly limit on this, which Original Medicare does not.
What is out-of-pocket costs?