Daily Knowledge Check
What are some things we are required to tell the beneficiary when we are completing an enrollment?
Recorded line, licensed agent in your state, Medicare A &B, SOA, post enrollment scripting, welcome packet and ID cards, PPO: in/out of network
Drugs(tiers), scripting about Rx: cost sharing, formulary coverage,
Will not be automatically enrolled, policy will not be changed without consent
MA(PD)/PDP will auto cancel after new one selected
Pharmacy in the network!
Drugs entered accurately
Daily Knowledge Check
What states have state specific rules for Medicare Supplement?
CALIFORNIA: year-round
OREGON: “birthday rule”
NEW YORK: year-round
MASS: only Medicare Core Plan, Medicare Supplement 1 and 1A
MISSOURI: “anniversary rule”
CONNECTICUT: year-round enrollment
Daily Knowledge Check
What is OEP N (OEP New) and how does it work?
OEP new is to ICEP/IEP as OEP is to AEP
Period of 3 months following start date of ICEP/IEP enrollment to use OEP-N
Allows the same lock-in period for ICEP/IEP enrollees that are available to AEP
enrollees
Daily Knowledge Check
What do we put in the notes?
Details about what happened on the call.
Who you called what information you gave.
What they were looking for
Daily Knowledge Check
If someone has an app status that can’t be verified, how do we find out more information?
Call the carrier.
Check the notes. (the enrollment team leaves notes about app status.)
Check in MARx.
Ask the beneficiary
Daily Knowledge Check
If the MBI is unavailable on the plates what are some other ways we can find information about a beneficiary?
Call the beneficiary.
Ask for SSI to look them up in MARx. “would you feel comfortable giving me your social security number?”
Do you have your medicare red white and blue card?
Call the carrier for Lis levels.
Partial MBI with name and DOB.
Daily Knowledge Check
Can you have Champ VA and prescription drug coverage?
Yes you can!
Medicare advantage pays first, then champ VA will pick up the rest.
Daily Knowledge Check
How long is the medicare supplement open enrollment period?
6 months from the first day of the month you turn 65 and are enrolled in Part B.
Daily Knowledge Check
What is not covered in Medigap plan G?
Part B deductible.
Plan N?
Part B deductible
Most things are covered, 80/20 coinsurance.
Plan A?
Part B Deductible
Part A deductible
Foreign travel
Coinsurance for SNF
Part B excess charges
Daily Knowledge Check
Generally speaking, what is the cheapest way someone can get their prescriptions?
Mail order.
PREFERRED pharmacy
Daily Knowledge Check:
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Who pays first with a medicare supplement?
Medicare!
Who pays first with Medicare Advantage?
Medicare Advantage
Who pays first with Dual Eligible Beneficiaries?
Medicare Advantage
medicare and medicaid – medicare pays first.
Who pays first with VA Tricare and Medicare Advantage?
Medicare Advantage.
...
Report it when you see it!
Reporting hotline.
Reporting email.
CMS form on medicare.gov.