Week 1

Question 1

What are the 6 types of Medicare Supplement Plans we offer?

Answer 1

A, B, C, F, F+, N

Question 2

Silver & Fit - In Network Cost

Answer 2

$25 every year

Question 3

Silver & Fit - Out of Network Cost

Answer 3

$150 reimbursed

Question 4

Silver & Fit - DVD cost

Answer 4

$10 for 2 DVDs

Question 5

What is Blue365?

Answer 5

Blue365 is a discount program exclusive to Excellus members. They must register online.
https://blue365deals.com

Question 6

What is TruHearing?

Answer 6

TruHearing is a hearing aid provider that provides a discounted rate to Excellus members. $699 for Flyte Advanced, $999 for Flyte Premium
https://truhearing.com

Question 7

What is the coinsurance for DME & Injectable Medication? Also, what does DME stand for?

Answer 7

20% In Network
30% OON
Durable Medical Equipment

Question 8

What are the 7 main benefits of having a Medicare Advantage plan as opposed to only having Parts A and B?

Answer 8

Vision
Wellness
Support
Dental
Rx
Hearing
24/7 help Online -- Nurseline

Question 9

What are the eligibility criteria for Medicare Advantage?

Answer 9

Needs to be enrolled in A and B
Cannot have End-Stage Renal Disease
Legal resident of New York counties
65+ or with disability

Question 10

What’s the main difference in eligibility criteria for Medicare Advantage vs. Supplemental plans?

Answer 10

You can have ESRD and get supplemental

Question 11

What is the Late Enrollment Penalty for Medicare Part D?

Answer 11

Multiply 1% of the national base beneficiary premium ($35.63 in 2017) by the # of uncovered months

Question 12

What are the 3 types of medical plans?

Answer 12

HMO (Health Maintenance Organization)
HMO-POS (Health Maintenance Organization - Point of Service)
PPO (Preferred Provider Organization)

Question 13

What are the main differences between the 3 types of medical plans we offer?

Answer 13

PPO does not require a PCP
HMO requires a referral for OON providers
HMO is In-Network only, HMO-POS is In&Out w/ capped amt., PPO is In&Out

Question 14

What does CMS stand for?

Answer 14

Centers of Medicare and Medicare Services

Question 15

What parts of Medicare do we work with?

Answer 15

Parts C, D, and Supplemental plans within D (also called MediGap)

Question 16

When was Medicare Part D created?

Answer 16

2006

Question 17

If you have Medicare Part C, you need ____ or you will receive a penalty.

Answer 17

Part D

Question 18

MediGap pays as ____ to Original Medicare.

We have ___ types of MediGap plans.

Answer 18

secondary

6

Question 19

Explain the difference between Excellus Health Plans, Excellus BCBS, and Univera

Answer 19

Univera and Excellus BCBS are two different health plans within Excellus’ Health Plans.

Question 20

Medicare Part A covers …

Answer 20

Inpatient care
Nursing facility care
Hospice
Home healthcare

Question 21

Medicare Part B covers …

Answer 21

Medical

Question 22

Medicare Part D covers …

Answer 22

Prescriptions

Question 23

Medicare Part C is also called …

Answer 23

Medicare Advantage

Question 24

If you are on the phone and you have an emergency/crisis, dial ____ to reach CSD.

Answer 24

33333

Question 25

Medicare Part C covers …

Answer 25

Facility-based
Professional
Optional prescriptions
Optional dental

Question 26

What’s the biggest difference between the deductibles/coinsurance/co-pays for Medicare Part A & B vs. Part C?

Answer 26

Parts A & B have a set deductible that is across the board for all members, whereas Part C has variable co-pays, deductibles, and coinsurance from plan to plan

Question 27

How often do you need to re-qualify for Medicare?

Answer 27

Never – once you qualify, there is no need to requalify.

Question 28

What are big exclusions of “traditional” Medicare (A & B) that can be covered under Medicare Advantage?

Answer 28

Drugs not administered by doctor
Some preventative care
Glasses and hearing aids
Immunizations
Routine foot care
Most dental services

Question 29

If a member says “Someone called me …”

Answer 29

Ask for the phone number.
Check our libraries to see if it was us. If not, try to google the number.
ALWAYS advise the member not to give out personal info if they don’t know who the caller is.
-> Ask if they gave personal info.
–> If YES, go into libraries and go through “cs2194…”
–> If NO, offer them the national Do Not Call List number
(888) 382-1222