Enrollment
The amount that must be paid for your health insurance or plan.
What is a premium?
This system is used to provide educational courses for continued learning.
What is LearnSource?
This covers
What is Medicare Part A?
The amount you could owe during a coverage period (usually one year) for health care services your health insurance or plan covers before your health insurance or plan begins to pay.
What is a deductible?
Health care services and supplies you get in your home under your doctor’s orders.
What is Home Health Care?
A provider focusing on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions.
What is a specialist?
This system is used to track issues and inquiries for Service Account Managers.
What is SMART?
This offers offers prescription drug coverage for everyone with Medicare.
What is Medicare Part D?
A list of drugs your plan covers.
What is a formulary?
This travel benefit allows eligible members to receive non-emergency covered services at in-network copayment/ coinsurance amounts when traveling outside their home service area.
What is the Passport Program?
A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service.
What is a copayment?
This system is used to find information-specific job aids, SOP’s, and other reference resources used by SAMs.
What is the Service Account Manager (SAM) Sharepoint?
This provides all of the Part A and Part B benefits and includes additional benefits such and vision and hearing.
What is Medicare Advantage (Part C)?
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment (DME) is medically necessary.
What is Pre-Authorization?
This occurs when you, or any other prudent layperson with an average knowledge of health and medicine, believe that you have medical symptoms that require immediate medical attention to prevent loss of life, loss of a limb, or loss of function of a limb.
What is a medical emergency?
When a provider bills you for the balance remaining on the bill that is not covered by your plan.
What is balance billing?
This system is used to look up electronic copies of ID cards and other material mailings.
What is Clarity?
Also called Medigap Plans, this helps pay the member's costs or the costs of Medicare-covered services.
What is Med Supplement?
This is the name of the UHC Company is used for prescription mail order services.
What is OptumRx?
A benefit that provides care and support for people who are terminally ill with a life expectancy of 6 months or less.
What is Hospice Care?
A type of health insurance plan that lets members use any health care provider, but will usually pay more of the member's costs when they get services from in-network providers.
What is a PPO?
This system is a Medicare Advantage and Prescription system used to look up specific information CMS has on file for a caller's Medicare benefits.
What is Marx?
This includes doctor visits and ambulance services.
What is Medicare Part B?
Out of the 4 phases, this is the last level if prescription drug coverage phases.
What is the Catastrophic phase?
This benefit gives you access to one Fitbit activity tracker at no additional cost every 2 years.
What is Renew Active?