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 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

Medicare

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