PDP
What is a dosage???
A specific quantity of medication to be taken within a specified period of interval
How long is the Open Enrollment (OE) time frame for Supplements?
6 months
What is the Initial Enrollment Period for Part B? (How do you qualify for it and what is the timeframe for a beneficiary to enroll)
When you are first eligible for Medicare you have a 7-month window to sign up for Part B. 3-1-3 (3 months before you are eligible, the month you become eligible, and 3 months after you are eligible)
T/F: Someone who is not drawing a monthly social security check will have their Medicare coverage start automatically when they turn 65
False
T/F: Disclosures and proper compliance are only important on calls that end in a sale.
False
To get a Part D plan, what parts of Medicare must the client be enrolled in?
Part A and/or Part B
Which 2 plans cover Part B Excess Charges?
Plan F and G
When/how do you become eligible for Original Medicare?
-Most people become eligible for Original Medicare when they turn 65 or after they have been disabled for 24 consecutive months. Also, people of any age with ESRD are eligible for Original Medicare.
How much is the beneficiary's coinsurance and deductible for Medicare Part B? How often must the deductible be met?
20% coinsurance $185 annual deductible
Name 2 FEATURES of your company
Represents the top A-rated carriers in the United States / We are one of the most competitive insurance advisory firms / We sell Medicare Supplements, Medicare Advantage Plans, Prescription Drug Plans as well as other products clients need (one-stop shop) / Agents are commission agnostic – our commission is not based on carrier, plan, or price
How much is the most a client will pay for their covered prescriptions while on Full Extra Help?
No more than: $3.40 for generic and $8.50 for brand name drugs.
What Medigap plan(s) is/are a client Guaranteed Issue for when in a Guaranteed Issue Window?
A, B, C, F, K, L
What is the enrollment period for beneficiaries who failed to sign up for Part B when they could have and when does it occur? When someone enrolls during this late period, when does their Part B coverage take effect?
General Enrollment Period- You can enroll from January 1st- March 31st. Part B coverage begins July 1st.
What do most Americans pay in 2019 for their Part B Premium?
$135.50 monthly premium for most Americans
What are the Four Parts to a Sales Call? (list them in order)
Introduction / Information Gathering / Pitch / Close
During Catastrophic Coverage, how much will the client pay for generic and for brand name drugs?
They will pay either 5% of the retail price OR $3.40 for generic drugs and $8.50 for brand name drugs, whichever is greater.
What are Part B Excess Charges?
The amounts that doctors are allowed to charge above the Medicare contracted allowable amount, up to 15%, if they do not accept Medicare Assignment.
During which enrollment period can you drop a PDP and move to Original Medicare alone or switch from one PDP to another? (Include dates)
Annual Enrollment Period - October 15th- December 7th
What is the cost of the Part A deductible in 2019 and how does the benefit period work?
$1,364 covers an inpatient say for a benefit period that lasts 60 days post discharge.
How long is a value proposition? What does it tell the client? (Looking for 2-3 things it does)
10-20 seconds. Tells the client Who we are / What we will do for them / The benefit of working with us vs. other companies and how that applies personally to the client
What is the Part D penalty? Why would one incur it and how is the amount determined? (Include 2019 costs)
A beneficiary will incur a Part D penalty if they fail to enroll for Part D coverage when first eligible and they do not have other creditable prescription drug coverage in place. If you are assessed a Part D penalty, you will pay an extra 1% of the National Average ($33.19 in 2019) on your monthly premium for each month you went without Part D coverage.
What is the FH deductible amount for 2019?
$2,300
Which enrollment period(s) do(es) not require medical underwriting for Medigap Plan(s) and for which plan(s)?
Open Enrollment -- all Medigap Plans Guaranteed Issue Window -- ABCFKL
List 2 services covered by Part A of Medicare and 2 services covered by Part B of Medicare.
Part A- inpatient hospital care, skilled nursing facilities, hospice care
Part B- outpatient care, doctors services, ER, ambulance, diagnostic tests, surgery center facility fees for approved procedures, Durable medical equipment
Make a PERSONAL value prop based on the client's situation: “I don’t like the Medicare plan I have now and want to switch”
Example: “Here at <Company Name> we represent the top A-rated carriers. We're able to shop those carriers in your area to find you the most comprehensive coverage at the most affordable rate...and find you a plan that actually fits your needs. Talking to me is like talking to multiple agents at once; a one-stop shop that helps you get your new coverage in place. And the best part about it: We will re-shop your plan each year to ensure that you continue to be in the plan that is most suitable to fit your needs and your budget in the future as well”