Annual Enrollment period (AEP) - Answer The AEP occurs October 15 through December 7 each year. During this time, all Medicare eligible beneficiaries
... [Show More] can enroll in, disenrollment from or change MA,, MA-PD or PDP plans. coverage changes made during the AEP are effective January 1 of the following year. If Medicare eligible beneficiaries do not make a change, their current coverage continues into the next year with any applicable premium or benefit design adjustments.
Appeal - Answer A Special kind of complaint members make if they disagree with certain kinds of decisions made by Medicare or their health of prescription drug plan. they can appeal if they request coverage for health care service care service, supply or prescription that they think they should be able to get or request payment for health care already received, and medicare or a plan denies the request, that can also appeal if they are already receiving coverage and the plan stops paying. there are specific processes that both the member and the plan must use for appeals.
Application Date - Answer The Application date is the date the enrollment request is received by the plan. this Includes the date it is received by a sales person.
Beneficiary - Answer The name for the person who has health care insurance through the Medicare of medical programe
Benefit period - Answer For Original Medicare, the benefit period begins on the first day of a hospital stay and ends when you have out of the hospital or skilled nursing facility for 60 days in a row. If you go into the hospital after one benefit period has ended a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have.
Catastrophic coverage - Answer Coverage that applies when a member has very high drug costs. for all Medicare prescription drug plans. it begins after a member has paid. $4,550 in 2014 out-of-pocket for covered drugs in a calendar year. Once this out-of-pocket level is reached the member pays the greater of 5 % of the cost for each coverd prescription of a small copy untill the end of the calendar year. [Show Less]