Medicare Basics
What are the three eligibility requirements for Medicare?
Anyone age 65 or older
Under age 65 with certain disabilities
People of any age with ESRD (End-Stage Renal Disease)
In GPS, what is the name of the button that allows you to enter the member's account after verifying their information?
Open Case
What is the name of the plan book which lists the most common benefits for a plan?
EOC (Evidence of Coverage)
Which system allows you to see the status of an appeal or grievance?
MEDHOK
CMS is also known as:
Center for Medicare and Medicaid Services
What are the four parts of Medicare?
Part A, Part B, Part C, Part D
What is the name of the tab in GPS where you can see a copy of the EOC (Evidence of Coverage)?
Healthpolicy Documents
What is the name of the handbook that Medicare sends every year to those who are eligible for Medicare?
Medicare & You
PNC
Medicare provides what type of insurance for eligible members?
Health insurance
Original Medicare
Medicare Advantage plan
What is the name of the tab in GPS where you search for providers?
Menu Navigation - Member - Find Care
What is the main system that you will log into every day at the beginning of the day?
GPS
What is the name of the government department that determines if the member is eligible for Medicare benefits?
SSA (Social Security Administration)
What is the Medicare ID number called?
MBI (Medicare Beneficiary Identifier number)
Email, telephone number, address, language preference
What timeframe does the Annual Enrollment Period (AEP) begin and end?
October 15th to December 7th each year
What is the name of the Medicare system that allows you to see the member's eligibility?
Marx
What color is the Medicare ID card?
Red white and blue
What are the two parts that a beneficiary must have in order to enroll in an Aetna Medicare Advantage plan?
Part A and Part B
What two numbers does the Aetna member ID number start with?
10-
A member's complaint or expression of dissatisfaction with the plan, provider, or customer service is called what?
Tableau