Queenie

Medications that are covered in a Plan’s formulary have various levels of associated member cost-sharing (copayments or coinsurance). What are these drug levels called? Drug tiers

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?   … Read more

Aside from a stand-alone Medicare Prescription Drug Plan, how else could a Medicare-eligible consumer get Part D prescription drug coverage? They could sign up for a pharmacy savings card through their local pharmacy.

When does Medicare Supplement Open Enrollment take place? During the three months prior to the consumer’s 65th birthday, the month of their birthday, and the three months following the month of their 65th birthday and enrolled in Medicare Part B.

Which of the following is NOT a correct statement about in-network provider services? HMO-POS Plans only cover in-network services.

Member Doug enrolled in a Health Maintenance Organization (HMO) MA Plan. He saw an out-of-network provider and received a bill for the entire cost of the visit. Doug called Medicare to complain and stated he was never told about these types of costs. What should the agent have explained better to Doug when he was … Read more

Which of the following defines a Medicare Advantage (MA) Plan? (Select 3) An MA Plan is part of Medicare and is also called Part C. An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often includes Medicare prescription drug coverage (Part D). An MA Plan is a health … Read more