SEP
The "SEP season" outside of OEP starts on what date?
What levels of Medicaid count as an SEP
All of them
What SEP is meant for a client who lost extra help
NLS
What SEP can be used once a Quarter?
MDE
LIS/Medicaid
What is the time frame to use moving SEP
30 days before 60 days after move
What's levels of extra help count as an SEP?
A client just used the Extra help SEP in March to get on a plan for April 1st. When can we use LIS again?
April
What SEP is meant for a client that lost Medicaid
MCD
What dates are considered SEP season?
Apr 1st - Oct 14th
What is the time frame to use IEP
3 months before, month of, and 3 months after getting parts A and B
When someone has Medicaid, the SEP code is MDE, what is the code for LIS on the app?
MDE
If a client has no SEP's, whats the next step?
LIS APP
If a client moved 2 weeks ago, what else must be true to use the move as an SEP?
Must have moved to a different Zipcode / City
What SEP can be used as "Last app in"?
MDE
What is the time frame to use ICEP
3 months before Part B
What SEP is used for a client who has had Part A for 3 years but is getting Part B in 2 months?
ICEP
A client used up their LIS SEP for the quarter to switch to the only Humana plan in the area. They don't live in a FEMA county. Which of the following SEP's can we potentially use?
a.) Medicaid
b.) Covid Fema
c.) Moving
d.) SPAP
Moving, Spap
Name 3 SEP's that can potentially be used besides the ones related to Extra help, Medicaid and moving.
SPAP
OCC
ICEP
IEP
Institutionalized
LOC / LEC
5 star
Name 3 SEPs can you see without having to ask the client?
FEMA
MDE
5 Star
What are the income limits for an LIS APP?
$1,700 Single
$2,300 Couple
Name two facilities that count as an "Institution" for an SEP and one that does not.
Does count : Nursing Home, Psychiatric hospital, Long term care hospital, Rehabilitation hospital
Does not count : Assisted living facility, Residential home
A VA client gets everything through the VA He currently has a Humana MA only plan. He heard about the Humana honor plan that gives him money back and wants that MA only plan instead. With this information, what SEP(s) can we use for sure?
Covid FEMA
We have a client in a FEMA county due to weather. After going over the other SEPs, no others apply. The client said they only want Healthnet, Wellcare or Humana. Which carriers can we put this client with?
Wellcare, Humana
A client is turning 65 next month but has already had Medicare for 7 years. What SEP can we use given this information?
IEP 2 - When a client already has Medicare due to disability but is turning 65. "Ageing in"
Name 4 SPAPS
IN - Hoosier Care
WI - Senior Care
PA - PACE
NY - EPIC
NJ - PAAD
WA - State insurance Pool
TX - Aids
CT - Husky Care