Medicare

Who is eligible to receive Medicare benefits?
Anyone in the U.S. Regardless of age
People aged 65 years or older
People under 65 with certain disabilities
Both B & C
What is Open Enrollment and when does it occur?
People can pick any plan they want/Occurs year-round
People can pick any plan they want/Occurs October 15 - December 7
People can pick from a predetermined list of plans only/Occurs year-round
People can pick from a predetermined list of plans only/Occurs October 15 - December 7
What types of Medicare plans are available?
PDP, MA-PDP, SNP
PDP, SA-PDP
PDP, MA-PDP, SNP, Medicare
PDP, MA-PDP
What are the 4 phases of Medicare coverage?
Deductible phase, Coverage Gap, Donut Hole, Catastrophic
Deductible phase, Coverage Gap (aka Donut Hole), Catastrophic, Terminal
Deductible phase, Coverage Gap, Terminal, Catastrophic
Deductible phase, Initial Coverage Limit, Coverage Gap (aka Donut Hole), Catastrophic
What does it mean to be Dual-Eligible?
Nothing, it's a made-up term
The patient qualifies for both MA-PDP and PDP plans
The patient qualifies for both Medicare and Medicaid benefits
The patient qualifies for either Medicare or Medicaid benefits
What are the types of subsidies that a Dual-Eligible patient can qualify for?
Full benefit dual eligible or full extra help, Partial extra help
Full benefit dual eligible or full extra help, Full benefit dual eligible and institutionalized or Receiving HCBS
Full benefit dual eligible, Partial extra help
Full benefit dual eligible, Full benefit dual eligible or full extra help, Full benefit dual eligible and institutionalized or Receiving HCBS, Partial extra help
What is the Medicare Star Rating System?
A system to measure how well MA-PDP and PDP plans perform
A system to measure how well pharmacies perform
A system to measure how well a patient takes his or her medication
A system to measure how well the government handles healthcare
What are the 5 medication-related components of the Star Rating System?
High-risk medications, diabetes treatment, medication adherence for diabetes , adherence for hypertension, adherence for cholesterol
High-risk medications, diabetes treatment, medication adherence for diabetes , adherence for hypertension, adherence for HIV
Low-risk medications, diabetes treatment, medication adherence for diabetes , adherence for hypertension, adherence for cholesterol
High-risk medications, hypertension treatment, medication adherence for diabetes , adherence for hypertension, adherence for cholesterol
What are DIR-Fees?
Direct and indirect remuneration fees that encompass a number of different types of fees for plans
Direct and indirect remuneration fees that encompass a number of different types of fees for Medicare
Direct and indirect remuneration fees that encompass a number of different types of fees for pharmacies
Direct and indirect remuneration fees that encompass a number of different types of fees for patients
 
 
When can a Dual-Eligible patient enroll in a plan?
They can enroll at any time during the entire year
They can enroll during Open Enrollment only
They can enroll at any time EXCEPT during Open Enrollment
They can enroll during the month of January only
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