AEP Final Exam
Four Key Parts to a Sales Call - ANS- Introduction
Information Gathering
Pitch
Close
T/F Get the disclosures out of the way in the Introduction - ANS- True
What do we Sell? - ANS- Medicare Advantage Plans
Prescription Drug Plans
Home Health Care
Hospital Indemnity
Critical Illness, etc
How do you qualify for Medicare? - ANS- 65 or older
Under 65 and have been on disability for 24 months
People of any age with ESRD
What is Original Medicare - ANS- Part A and Part B
T/F If you're collecting Social Security then you'll automatically be enrolled in Original
Medicare when you turn 65 - ANS- True
What does Part A, Hospital Insurance, cover? - ANS- Inpatient care
Critical access hospitals and Skilled Nursing Facilites
Hospice Care
Some Home HealthCare (if they meet certain conditions)
What are the costs involved with Part A? - ANS- $1288 Deductible - covers 60 days post
discharge
$322 co-pay PER DAY for days 61-90
$644 co-pay PER DAY for days 91-150
Put Part A into context - ANS- Part A, under original medicare, covers inpatient services.
With Part A you are responsible for a $1288 deductible. And that deductible can occur
every 61 days. So you might be hospitalized and pay the deductible and then pay it again
if you are hospitalized 61 days later, even if you are hospitalized for the same condition.
What does Part B, Medical Insurance, cover? - ANS- Out patient care
Doctors visits (not routine physical exams)
Outpatient medical and surgical services and supplies
, Diagnostics Tests
Ambulatory surgery center facility fees
Durable Medical Equipment
Outpatient mental health, outpatient physical/occupational therapy...including speech
therapy
What does Part B cost? - ANS- -Monthly premium - $104.90 prior to 2016. $121.80 as of
2016
-Annual deductible - $166
-20% coinsurance of the Medicare-approved amount for services after the annual
deductible is met
Put Part B into context - ANS- Part B, under original medicare, covers outpatient
services. The average Part B premium is $104.90 and there is an annual $166 deductible.
Medicare pays for 80% of the doctor bill, leaving you exposed to the remaining 20%. And
there is no cap on that exposure. Meaning you could have a $100,000 bill, leaving you
exposed to $20,000.
What enrollment periods pertain to Part B - ANS- -IEP-Initial Enrollement Period.
3-1(65)-3
-SEP-8 month window that starts the month after the employment ends or group health
plan ends. Whichever 1st
-GEP-Jan 1-March 31. Effective July 1st
Explain Part B penalty - ANS- Penalty occurs when
-You don't enroll in Part B when eligible and you're not enrolled in creditable coverage.
-You drop Part B and then get it later
**10% of the premium for each full 12 month period that you could have had Part B, but
didn't sign up for it.
**The penalty never leaves you.
Creditable Coverage - ANS- A term used by Medicare to describe a non-Medicare health
plan that is considered to be at least as good as the coverage offered by original
Medicare
What is Part D of Medicare - ANS- A Medicare program that provides prescription drug
coverage regulated by Medicare, but designed and provided through private insurance
companies.
How do you qualify for a Medicare Pard D (PDP) - ANS- -If you have Part A AND/OR Part
B
-You must either purchase the drug plan (Stand Alone PDP) OR
-Enroll in a Medicare Advantage Plan including PDP (MAPD)
Four Key Parts to a Sales Call - ANS- Introduction
Information Gathering
Pitch
Close
T/F Get the disclosures out of the way in the Introduction - ANS- True
What do we Sell? - ANS- Medicare Advantage Plans
Prescription Drug Plans
Home Health Care
Hospital Indemnity
Critical Illness, etc
How do you qualify for Medicare? - ANS- 65 or older
Under 65 and have been on disability for 24 months
People of any age with ESRD
What is Original Medicare - ANS- Part A and Part B
T/F If you're collecting Social Security then you'll automatically be enrolled in Original
Medicare when you turn 65 - ANS- True
What does Part A, Hospital Insurance, cover? - ANS- Inpatient care
Critical access hospitals and Skilled Nursing Facilites
Hospice Care
Some Home HealthCare (if they meet certain conditions)
What are the costs involved with Part A? - ANS- $1288 Deductible - covers 60 days post
discharge
$322 co-pay PER DAY for days 61-90
$644 co-pay PER DAY for days 91-150
Put Part A into context - ANS- Part A, under original medicare, covers inpatient services.
With Part A you are responsible for a $1288 deductible. And that deductible can occur
every 61 days. So you might be hospitalized and pay the deductible and then pay it again
if you are hospitalized 61 days later, even if you are hospitalized for the same condition.
What does Part B, Medical Insurance, cover? - ANS- Out patient care
Doctors visits (not routine physical exams)
Outpatient medical and surgical services and supplies
, Diagnostics Tests
Ambulatory surgery center facility fees
Durable Medical Equipment
Outpatient mental health, outpatient physical/occupational therapy...including speech
therapy
What does Part B cost? - ANS- -Monthly premium - $104.90 prior to 2016. $121.80 as of
2016
-Annual deductible - $166
-20% coinsurance of the Medicare-approved amount for services after the annual
deductible is met
Put Part B into context - ANS- Part B, under original medicare, covers outpatient
services. The average Part B premium is $104.90 and there is an annual $166 deductible.
Medicare pays for 80% of the doctor bill, leaving you exposed to the remaining 20%. And
there is no cap on that exposure. Meaning you could have a $100,000 bill, leaving you
exposed to $20,000.
What enrollment periods pertain to Part B - ANS- -IEP-Initial Enrollement Period.
3-1(65)-3
-SEP-8 month window that starts the month after the employment ends or group health
plan ends. Whichever 1st
-GEP-Jan 1-March 31. Effective July 1st
Explain Part B penalty - ANS- Penalty occurs when
-You don't enroll in Part B when eligible and you're not enrolled in creditable coverage.
-You drop Part B and then get it later
**10% of the premium for each full 12 month period that you could have had Part B, but
didn't sign up for it.
**The penalty never leaves you.
Creditable Coverage - ANS- A term used by Medicare to describe a non-Medicare health
plan that is considered to be at least as good as the coverage offered by original
Medicare
What is Part D of Medicare - ANS- A Medicare program that provides prescription drug
coverage regulated by Medicare, but designed and provided through private insurance
companies.
How do you qualify for a Medicare Pard D (PDP) - ANS- -If you have Part A AND/OR Part
B
-You must either purchase the drug plan (Stand Alone PDP) OR
-Enroll in a Medicare Advantage Plan including PDP (MAPD)
