Mr. Katz reached… Mr. Katz reached the Part D coverage gap in August last year. His prescriptions have not changed, he is keeping the same Part D plan and the benefits, cost-sharing, and coverage of his drugs are all the same as last year. He asked what to expect for this year about his out-of-pocket … Read more

The Part D… The Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on the Value Script and Value Plus products True

What types of tools…. What types of tools can Medicare Part D prescription drug plans use that affect the way their enrollees can access medications? Part D plans do not have to cover all medications. As a result, their formularies, or lists of covered drugs, will vary from plan to plan. In addition, they can … Read more

Medicare health plans… Medicare health plans establish provisions in marketing representative contracts to ensure compliance with applicable laws and policies. If non-compliance occurs, CMS can penalize a plan in which of the following ways? CMS requires plan sponsors to create and complete a corrective action plan and may terminate a sponsor’s contract.

You are scheduled…. You are scheduled to give a sales presentation at a local senior center. At the beginning of the presentation, which of the following must you do? Clearly state that NO obligation exists to enroll if a gift or prize is being offered.

Which of the… Which of the following would be considered PHI? An individual’s first and last name and the medical diagnosis in a physician’s progress report

Mr. Chen is enrolled… Mr. Chen is enrolled in his employer’s group health plan and will be retiring soon. He would like to know his options since he has decided to drop his retiree coverage and is eligible for Medicare. What should you tell him? Mr. Chen can disenroll from his employer-sponsored coverage to elect … Read more