Special Enrollment Period
Give this one a try later!
Individual can enroll at 8 months beginning with the month employment
ends or when group coverage ends whichever is earlier without subject to
late enrollment surcharge
,Medicaid
Give this one a try later!
Government insurance program for low income & indigent people
-Jointly funded by state & federal
-Managed by state
-CMS monitors program & establishes standards
-Applies thru DSS office
-Based on income, assets & must have income below poverty level to
receive benefits
Medicare Part B covers
Give this one a try later!
-Medical & surgical services incl. anesthesia, x-rays, med supplies, phys
therapy, administered drugs
-Diagnostic tests & procedures that are part of tx
-Radiology & pathology (in- or out-patient) including radiation therapy
-Mental illness tx as inpatient or under partial hospitalization. (Mental
health tx in non-hospital outpt setting will receive pymt of 80% of
approved charges)
-Chiropractic services for manual manipulation of spine to correct
dislocation confirmed by x-ray
-Podiatrist to treat injuries or disease of the foot
-Optometrist but not for routine care
-Dental services if medical problem & dentist is involved in corrective
procedure
Med Supp Application & Replacement
, Give this one a try later!
-Both applicant & agent must sign application containing terms designed to
disclose duplicate or replacement policies
-Agents shall list any other health policies they've sold to applicant within
the last 5 years that are no longer active.
-If replacement, "Notice Regarding Replacement of Medicare Supplement
Insurance" must be signed by both agent & applicant with each retaining a
copy.
-Insurer must waive time periods if already fulfilled under original policy.
e.g. probationary periods, etc...
-Individual cannot have more than 1 such policy. Illegal for agent to sell a
Medigap to someone who has Medicare Advantage unless switching to
original Medicare.
Med Supp Disclosure Provisions
Give this one a try later!
-"Outline of Coverage" must be provided at time of application & a signed
acknowledgement of receipt from applicant must be collected.
-Must include renewal or continuation provision on first page
-Riders added after issuance that affects policy coverage & premium must
have a signed acceptance from insured
-"Reasonable & Customary" must define the term & explained in outline of
coverage.
-ALL supplement policies MUST have a 30 Day Free Look Period
-All applicant must be provided a NC Buyer's Guide from NAIC AND a
Medicare Supplement Buyer's Guide from CMS at time of application.
Participating Doctor
Give this one a try later!
Give this one a try later!
Individual can enroll at 8 months beginning with the month employment
ends or when group coverage ends whichever is earlier without subject to
late enrollment surcharge
,Medicaid
Give this one a try later!
Government insurance program for low income & indigent people
-Jointly funded by state & federal
-Managed by state
-CMS monitors program & establishes standards
-Applies thru DSS office
-Based on income, assets & must have income below poverty level to
receive benefits
Medicare Part B covers
Give this one a try later!
-Medical & surgical services incl. anesthesia, x-rays, med supplies, phys
therapy, administered drugs
-Diagnostic tests & procedures that are part of tx
-Radiology & pathology (in- or out-patient) including radiation therapy
-Mental illness tx as inpatient or under partial hospitalization. (Mental
health tx in non-hospital outpt setting will receive pymt of 80% of
approved charges)
-Chiropractic services for manual manipulation of spine to correct
dislocation confirmed by x-ray
-Podiatrist to treat injuries or disease of the foot
-Optometrist but not for routine care
-Dental services if medical problem & dentist is involved in corrective
procedure
Med Supp Application & Replacement
, Give this one a try later!
-Both applicant & agent must sign application containing terms designed to
disclose duplicate or replacement policies
-Agents shall list any other health policies they've sold to applicant within
the last 5 years that are no longer active.
-If replacement, "Notice Regarding Replacement of Medicare Supplement
Insurance" must be signed by both agent & applicant with each retaining a
copy.
-Insurer must waive time periods if already fulfilled under original policy.
e.g. probationary periods, etc...
-Individual cannot have more than 1 such policy. Illegal for agent to sell a
Medigap to someone who has Medicare Advantage unless switching to
original Medicare.
Med Supp Disclosure Provisions
Give this one a try later!
-"Outline of Coverage" must be provided at time of application & a signed
acknowledgement of receipt from applicant must be collected.
-Must include renewal or continuation provision on first page
-Riders added after issuance that affects policy coverage & premium must
have a signed acceptance from insured
-"Reasonable & Customary" must define the term & explained in outline of
coverage.
-ALL supplement policies MUST have a 30 Day Free Look Period
-All applicant must be provided a NC Buyer's Guide from NAIC AND a
Medicare Supplement Buyer's Guide from CMS at time of application.
Participating Doctor
Give this one a try later!
