Medicare
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Federal health insurance program
What is a preferred pharmacy?
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A contracted network pharmacy that offers medicare part D members
covered Part D drugs at negotiated prices. The prices are lower levels of
cost-sharing than apply at a non-preferred (standard) pharmacy
what is deeming?
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a key feature of a PFFS plan is that the member can choose their health
care provider both at home and when they travel in the US
Chronic condition SNP?
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people who have certain chronic medical conditions
Institutional SNP?
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Nursing homes
Medicare is administered by whom?
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CMS ( Centers for medicare and medicaid services)
How does MSA plans work?
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the plan deposits money from emdicare in the account which can then be
used to pay for medical expenses until their deductible is met
If a customer is enrolled in a state medicaid program, explain to them that a PFFS plan
may
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Impact their ability to continue seeing their current providers, and may
create OOP expenses they may not be able to afford.
Part A?
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Hospital insurance
, to be enrolled in the MTM program ( medication therapy program) the enrolled
member must meet all of the following
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1) member has more than one chronic health condition
2) Member takes several different medications
3) Member's medications have a combined cost of more than $3,919 per
year
( the dollar amount can change per year) is estimated based on OOP costs
and the costs the plan pays for the medications each calendar year. the
plan can help members determine if they may reach this dollar limit.
MA plans integrate what type of additonal coverage?
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part D prescription drug coverage
does an employer senior supplement group retiree plan help pay for some or all the
costs not covered by original medicare?
Give this one a try later!
yes. not only that but they have similar coverage as medicare supplement
insurance plans and members can go to any provider that accepts
medicare
Give this one a try later!
Federal health insurance program
What is a preferred pharmacy?
,Give this one a try later!
A contracted network pharmacy that offers medicare part D members
covered Part D drugs at negotiated prices. The prices are lower levels of
cost-sharing than apply at a non-preferred (standard) pharmacy
what is deeming?
Give this one a try later!
a key feature of a PFFS plan is that the member can choose their health
care provider both at home and when they travel in the US
Chronic condition SNP?
Give this one a try later!
people who have certain chronic medical conditions
Institutional SNP?
Give this one a try later!
Nursing homes
Medicare is administered by whom?
,Give this one a try later!
CMS ( Centers for medicare and medicaid services)
How does MSA plans work?
Give this one a try later!
the plan deposits money from emdicare in the account which can then be
used to pay for medical expenses until their deductible is met
If a customer is enrolled in a state medicaid program, explain to them that a PFFS plan
may
Give this one a try later!
Impact their ability to continue seeing their current providers, and may
create OOP expenses they may not be able to afford.
Part A?
Give this one a try later!
Hospital insurance
, to be enrolled in the MTM program ( medication therapy program) the enrolled
member must meet all of the following
Give this one a try later!
1) member has more than one chronic health condition
2) Member takes several different medications
3) Member's medications have a combined cost of more than $3,919 per
year
( the dollar amount can change per year) is estimated based on OOP costs
and the costs the plan pays for the medications each calendar year. the
plan can help members determine if they may reach this dollar limit.
MA plans integrate what type of additonal coverage?
Give this one a try later!
part D prescription drug coverage
does an employer senior supplement group retiree plan help pay for some or all the
costs not covered by original medicare?
Give this one a try later!
yes. not only that but they have similar coverage as medicare supplement
insurance plans and members can go to any provider that accepts
medicare
