Election Periods
Part A 01/01/2020
Part B 07/01/2021
What election code would be used to complete this enrollment?
Delayed Part B - ICEP
Lead has resided in current location for 5 months now but did not report the move to SS or Medicare. What election code can you use today to assist the lead in changing plans?
Using tone, welcoming statements and showing empathy in the introductions as a way to establish a connection?
What is Rapport?
This program can help reduce a Medicare Advantage plan premium,
What is LIS/Extra Help?
A unique number from Sunfire that must be provided to the lead at the end of the enrollment.
What is a Confirmation Number?
Part A & B dates are 04/01/2021. Lead is looking for a MA only plan to start 05/01/2021. What election code would be used in this scenario?
ICEP
SNP more suited for someone with Medicaid.
What is a D-SNP?
The reasons why consumers are influenced to purchase?
What are afflictions & aspirations?
Program helps pay for Part A premiums Part B premiums Deductibles, coinsurance, and copayments
What is QMB?
In reviewing this plan type, you must discuss both in network and out of network cost. (2 Answers)
What is a PPO? What is a HMO-POS?
Lead's recently enrolls using IEP, 04/01/2021 start dates for A/B. Plan becomes effective 4/01/21. It's now May and lead wants to make changes. According to the hierarchy, which election period would be used?
MA-OEP New
In order to use Disaster SEP, lead must reside in service area of disaster and must also have what?
Missed Election Period
This section of the script is used to discover what lead currently has and determine if there's a need to fulfill.
What are Qualifying Questions?
A state program that helps pay Part B premiums for people who have Part A and limited income and resources.
What is SLMB?
You must use network pharmacies except under non-routine circumstances, quantity limits, copayments, and restrictions may apply.
What is Pharmacy Disclosure?
General Medicare Enrollment Period: If you miss your Initial Enrollment Period, you can sign up during Medicare’s General Enrollment Period (January 1–March 31), and your coverage will start?
July 1st
Lead is champ VA and currently has MAPD plan. Lead is looking to explore options outside the VA to get additional benefits like dental and vision. Lead does not take any Rx. Given the scenario, what election code would allow this lead to make a change?
OCC- Other Creditable Coverage
A statement which requires a clear yes and must be read verbatim in order to discuss Medicare Advantage plans.
What is a SOA?
Leads that have QMB, SLMB or QI will automatically receive this additional assistance.
What is LIS/Extra Help?
Please note that if Medication is not covered by the formulary you will be responsible for 100% of the retail cost.
Lead refuses to look up Medication. What is Formulary Disclosure?
Lead has been on Medicare's A/B since 2003, lead is approaching 65th birthday next month and interested in making plan changes. Which election code would be used to assist this lead in making this change?
What is IEP2
It's 4/15/2021, lead has just made a change in February, March and again last 4/10/2021. Assuming this scenario, which SEP would be used to complete the enrollment for a 5/01 start sate?
What is MDE?
Plan Premium, Deductibles, Primary Care, Specialist, In Patient Hospital, Emergency Room, Urgent Care, Maximum Out of Pocket
What are Baseline Benefits?
Lead recently had a loss, gain, or change in your Medicaid?
What is MCD?
Failure to look these up will impact placement and likely cause allegation?
Provider and Medication look up