CMS Guide Lines
Medicare
Compliance and Elections
Need to Know
Random
100

What does the Acronym IRMA stand for?

What is Income Related Monthly Adjustment.

100

What is covered under Medicare Part D?


What are Prescription Drugs?

100

Starting in 2019 a person with Medicaid can change plans unlimited number of times. True or False?

What is False?

100

When is the NEW Medicare Advantage plan Disenrollment Period started in 2019?

What is January 1 to March 31st?


100

What year was WellCare founded?


What is 1985?

200

 What is the name of (sales events) like traditional  Sale seminars, group sales events, or  Sales presentations?

What is a Formal Event?

200

 What is the Medicare Part A Deductible for 2019?


What is $1,364.00?


200

After you complete your presentation; Are you are allowed to leave your business cards with the beneficiary?


What is Yes?


200

What is the new election code for beneficiaries that did not receive their materials in time to enroll when before their Part A and B effective date?

What is ACC?

200

What is the True out-of-Pocket Threshold (TROOP) in 2019?


What is $5100?


300

 You cannot serve more than ____ snack-sized items at a sales event?


What is 10?

300

 What is the Medicare Part B Deductible for 2019?


What is $185?


300

Tamara is aging into Medicare and is in her 7 month initial election period. She would like to enroll in a MA-only (no RX). Which enrollment period Tamara qualify?


What is Initial Coverage Enrollment or ICEP?


300

What are the most common Chronic Special Needs Plans medical conditions? ( 3 answers )

What are Diabetes, Heart Disease (CHF, CVD), COPD?

300

You must not be able to perform substantial work because of your medical condition and your medical condition must have lasted, or are expected to last, at least one year or result in death. What is this called?



What is SSA's definition of "Disabled"?


400

 What time frame can an agent present the benefits for the next plan year, but cannot accept a completed application? 


What is Pre- AEP/October 1st -October 14th?


400

 What is covered under Medicare Part A?


What is Hospital and Inpatient Services?


400

Oscar delayed his Part B when he was first eligible. He enrolled into Part B after the expiration of his IEP. He is requesting to enroll in a  MAPD plan in the 3 months prior to his Part B effective date. Which enrollment period should Oscar qualify for?



What is Initial Enrollment Period or ICEP?


400

What is the 5 Star plan we at FMO can sell in Florida? 


What is CarePlus?


400

What is a request to the plan from a member or provider for a formal review of an Action (Denial) or adverse plan determination (Medicare)?


What is an Appeal?


500

John is aging into Medicare and joining an MAPD for the first time. What enrollment period will he use?


What is Initial Election Period or IEP?


500

Medicare Part C is also known as.


What is a Medicare Advantage Plan?


500

What election period allows you to make a change in coverage after you have chosen a plan for your Initial Election Period? Up to 2 months after IEP or ICEP.


What is OEP NEW?


500

The system allows customers to connect with their public assistance information, through the online application. Customers look for these places for State programs for low income recipient.


What is Families Automated Community Connection to Economic Self Sufficiency (ACCESS) or My Access Florida?


500

 How long does the Grievance Department have to verbally acknowledge via phone a CCP grievance after it is filed?


What is 3 Business Days?