True or False: Kaiser Permanente offers a Medicare Senior Advantage and Medicare Advantage plan. Both plans provide members with a comprehensive set of
... [Show More] benefits. These plan offerings are based on the Kaiser Permanente Market service area.
True
Fill in the blank. Kaiser Permanente Senior Advantage is a _ plan.
MAPD
Brainpower
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Kaiser Permanente Washington and Mid-Atlantic States offer which Medicare Advantage plans?
Both Medicare Advantage with and without Prescription Drug coverage.
KPSA and MA members are expected to obtain their health care:
Only at a Kaiser Permanente or contracted health care facilities or pharmacies (except for certain urgent care and emergency-related services)
To be eligible for KPSA and MA , an individual must:
Be entitled to Medicare Part A and enrolled in Medicare Part B
To be eligible for KPSA and MA, an individual must:
Permanently reside within the KP Medicare service area.
Advantage plus is an optional supplemental plan that - at an additional monthly premium.
Provides extra benefits (such as vision, dental, and/or hearing coverage)
In CA, this plan is named the Medicare Medi-Cal plan. Senior Advantage Special Needs Plan members who lose their Medicaid Status can maintain their KP membership by submitting an abbreviated election for for enrollment into the Senior Advantage Individual Plan.
The form must be submitted within - days.
120
To be eligible for the Senior Advantage Special Needs plan, an individual must already have -.
Both Medicare Part A, Part B, and Medicaid
Individuals with Medicare and Medi-Cal qualifies for a Special Election Period and can enroll or disenroll -.
Once per quarter during the first 3 quarters of the year.
At Kaiser Permanente, -- apply to the MOOP (max out of pocket)
all Medicare covered services (Parts A&B)
What is the correct Prescription Drug Coverage tier for: Non-preferred Brand name drugs?
Tier 4
What is the correct Prescription Drug Coverage tier for: Non-preferred Generic Drugs?
Tier 2
What is the correct Prescription Drug Coverage tier for: Injectable Part D vaccines?
Tier 6
What is the correct Prescription Drug Coverage tier for: Preferred Generic Drugs?
Tier 1
What is the correct Prescription Drug Coverage tier for: Specialty Tier
Tier 5
What is the correct Prescription Drug Coverage tier for: Preferred Brand name drugs?
Tier 3
Under KP's Medicare Prescription Drug Benefit, injectable Part D vaccines are covered at no charge:
At any coverage stage (in most plans)
You are looking up the cost sharing for a member's prescription. After finding the drug tier level in the formulary, you will look up the cost in the:
Summary of benefits
Lower copays for selected chronic condition drugs are in - (in most plans)
Tier 1, preferred generic [Show Less]