Which of the following best describes the Late Enrollment Penalty (LEP)?
The amount added to the member's monthly plan premium if they did not enroll in
... [Show More] a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for 63 or more continuous days.
Which of the following statements is NOT TRUE about the Coverage Gap?
All members reach the Coverage Gap
Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are all examples of what?
Utilization Management Rules
What is the amount added to the member's monthly plan premium if they did NOT enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for 63 or more continuous days?
WRONG ANSWER Late Enrollment Premium (LEP) WRONG
Can a consumer who qualifies for Low Income Subsidy receive financial assistance for their part of Medicare Part D costs?
Yes, through subsidies such as lower or no monthly plan premiums and lower or no copayments
Formulary is defined as
A list of medications covered within the benefit plan, based on CMS guidelines and developed in collaboration with physicians and pharmacists.
When is a Medicare Supplement Insurance consumer subject to underwriting and screened for eligibility?
When the consumer is not in their Medicare Supplement Open Enrollment or does not meet Guaranteed Issue criteria.
Which of the following is NOT true about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) impact to Plans C and F?
Consumers already enrolled in Plans C or F are required to change plans.
Which of the following is true about Medicare Supplement Insurance Plans?
Plan benefit amounts automatically update when Medicare changes cost sharing amounts, such as deductibles, coinsurance and copayments.
Milton is retiring on his 65th birthday. He is eligible for Medicare and already receives Social Security benefits. How does he enroll in Original Medicare?
His enrollment in Medicare Parts A and B is generally automatic if he meets all eligibility requirements
Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to enroll in a Medicare Supplement Insurance Plan?
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA plan.
Provided other eligibility requirements are met, who is eligible for Medicare?
Consumers age 65 or older, consumers under 65 years of age with certain disabilities for more than 24 months and consumers of all ages with ESRD or ALS
Which of the following defines a Medicare Advantage (MA) Plan? (Select 3)
An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often includes Medicare prescription drug coverage (Part D). [Show Less]