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10 Cards in this Set
- Front
- Back
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TRUE or False: Enrollment works with Social Security to ensure a member is disenrolled or enrolled in our plan.
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FALSE. Enrollment works with medicare
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If my father calls in November 2012 to disenroll from your plan and he does not have a SEP, what will his effective date be on the new plan?
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January 1st
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What are the dates for the Annual Enrollment Period (AEP) for 2012?
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October 15th-December 7th
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Can you tell me more about the Open Enrollment Period for Institutionalized Individuals?
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It is continuos for them and also open for 2 months after they leave the insitution
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Between January 1 and February 14 are the dates for what enrollment period?
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Medicare Advantage Disenrollment Period (MADP)
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My dad submitted a request to disenroll from your plan on February 12, 2012 when will be his effective date on his new plan?
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It will be effective on the 1st of the following month
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TRUE or FALSE: The initial enrollement period is only the 3 months before and after the individual turns 65
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FALSE. The initial enrollment period is 3 months before they turn 65 and the birth month and 3 months after they turn 65
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Provide two examples of why a Member would qualify for a Special Enrollment Period
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-Emplyer/Union group health plan changes
-CMS Sanction -Change in LIS status -Medicare entitlement determination made retroactively -Change in special needs status- Chronic Care SNPs -Change in SPAP (State Pharmacy Assistance Programs) -Marketing misrepresentations -Moving out of a plans service area |
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This is the yearly period in which an individual can choose to stay on a Medicare Advantage Plan, switch their healthcare plan or go back to Original Medicare?
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Annual Election Period
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If a member calls to rejoin the plan after he had just disenrolled to join another plan, what category/subcategory would be used to document the call?
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FE 308
Change to reinstatement Request |
