Original Medicare, Midterm................... Lessons 1-4a, Final Exam

Original Medicare, Midterm................... Lessons 1-4a, Final Exam A wheelchair would fall under which part of Medicare and why? - Part B; it would fall under Durable Medical Equipment Abigail is cost share protected, and which plan would you recommend for her and why? - D-Snp because most likely she is on medicaid. So they would qualify for dual eligible. After inputting the client's information, what do you need to click before going to the quote engine? - save; when you save in select care it automatically updates to the quote engine Angelica is 37 and she has been collecting social security for 12 months. As of today, will she be automatically enrolled in Medicare? - No enrollment period You have to be on social security for 24 months in order to be enrolled Benefits of a Part D plan? - Keeps you from accruing the penalty Cuts down prescription drug costs Bob is 67 and has had insurance under his employer since he was eligible for Medicare at 65. He was automatically enrolled in Part A, but deferred part B. He's planning on retiring on May 1st. Today is January 15th, what enrollment period does he qualify for? Why or Why not? Are there any penalties? If no when can he enroll? How long can he wait without penalty? (3 points) - None right now, since he hasn't retired to drop his employer's coverage. Special enrollment period begins the month after coverage loss. He will not receive a penalty because he held credible coverage. He can wait until he retires and June 1st- jan 31st will be his special enrollment period Carmen is turning 65 on November 5th, when will her Medicare Part A coverage begin? - November 1st Chance turned 65 on March 15th, and enrolled in Original Medicare alone. Today is August 20th, 2016 and Chance decides that he wants to enroll in a MAPD. What enrollment period for a MAPD is he in as of today? When is the earliest his plan can take effect? - There is no enrollment period Chance has to wait until AEP and his plan will start on January 1st. Clarence is turning 65 on January 1st, when will his Medicare Part A coverage begin? - December 1st; If the birthday lands on the first, Medicare will begin on the first of the previous month Daniel is 67 and losing employer coverage and wants to join a Medigap plan. What enrollment period does he qualify for and which plans can he enroll in without medical underwriting - A: 60 days before and 63 days after losing creditable coverage. ABCFKL. Dean is on original Medicare alone and moved recently, what are his plan options? - Get into a Medigap plan with underwriting Join a MAPD/ PDP/ MA - 2 month SEP Elizabeth is eligible for both Medicare and Medicaid. What does this allow her to do? - A: Elizabeth is Dual-Eligible so she can join, switch, or drop a MA/MAPD/PDP. This gives her a year-round SEP. Explain credible coverage. - a non-Medicare health plan that is considered to be, at least, as good as Medicare covergae Hospice care will be covered under which part of Original Medicare? - Part A How can you determine if a client has a subsidy? - go to M How do you add a Ms. Jones husband to the plan you are quoting her? - Click Add New Individual How do you find out how many inbound leads you have taken? - Look under Answered on softphone bar. How do you qualify (or get disqualified) for Part C? (3 points) - Must be enrolled in Medicare A AND B Must continue to pay Part B premium Must pay MA/MAPD premium if applicable Cannot Have ESRD How do you sign up for Part B when you aren't automatically enrolled? - Call 1800 Medicare, contact your local social security office, or visit the website How long are MAPD's contracted for? - 1 year. Runs January 1-December 31st How long is the election period for individuals on a CSNP plan? And when is this period? - Clients will have a Once a year Election period. They can change their plan once a year whenever they want. But only once per calendar year. How long is the SEP for a PDP/MA/MAPD and what qualifies a client for one? (2 points) - 2 months after a qualifying event Moved out of county, loss of creditable coverage, released from prison How long is the window for the initial enrollment period? Explain how it d