AARP Medicare Supplement Insurance Plans Certification Test

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AARP Medicare Supplement Insurance Plans Certification Test AARP an its affiliates are not - ✔✔insurers med sup plans cover some or all OOP expenses for medicare eligible care such as - ✔✔ ... medicare coinsurance copayments deductibles before enrolling your consumer, make sure you have presented and the consumer - ✔✔understands ALL COSTS associated with the plan what is helpful for explaining costs to the consumer - ✔✔the enrollment kit who regulates med sup insurance - ✔✔each states department of insurance _____ automatically update to match annual changes to original medicare coinsurance, copayments, and deductibles - ✔✔plan benefits are med sup plans available all year round? - ✔✔yes if leaving a MA plan for a med sup plan, disenrollment is NOT what? - ✔✔automatic to disenroll, the consumer must contact who and join what - ✔✔must contact the MA carrier or join a part D plan ( PDP) what happens if the insured member cancels within 30 days after coverage begins? - ✔✔premiums are refunded less any claims paid What does MACRA stand for? - ✔✔Medicare Access and CHIP Reauthorization Act of 2015 When does the new MACRA legislation go into effect? - ✔✔jan 1st 2020 and it affects a consumer's qability to enroll in plans C and F Consumers eligible for Medicare Part A before janurary 1, 2020 - ✔✔can enroll in plans C and F even after jan 1st 2020 and can keep their plans as long as they choose Consumers newly eligible for Medicare Part A on or after jan 1, 2020 - ✔✔will NOT be able to purchase Medicare sup insurance Plans C or F Consumers already enrolled in plans C or F do NOT need to - ✔✔take any action and they can keep the plan they have if they choose to be eligible for med sup insurance, a consumer must: - ✔✔be enrolled in Medicare parts A and B at the time of the plans effective date Be a resident of the state in which he/she is applying for coverage ( usually residency is defined as the location where the consumer files their tax return) be age 65 or older ( some states require insurers to offer coverage for medicare beneficiaries under age 65) A consumer may NOT be eligible for Med sup insurance for various reason, including but not limited to the following: - ✔✔consumer does not qualify for med sup open enrollment or guaranteed issue and does not pass medical underwriting Consumer is enrolled in another med sup plan or a MA plan which they do not intend to replace under federal law, med sup open enrollment is the - ✔✔first 6 months a consumer is 65 or older and enrolled in medicare part B. some states have additional open enrollments when a consumer first enrolls in Medicare Part B at age 65 or older, they have a ______right to buy a medicare sup insurance policy for 6 months - ✔✔guaranteed right in most states, they can apply 3 months prior to the start of their - ✔✔medicare initial enrollment period ( IEP) during this time, an insurer must offer a consumer any plan it sells and CANNOT charge consumers more for a policy because of... - ✔✔past or present health problems if a consumer does not apply during heir Med sup open enrollment, they can apply at any time, but they may be_____ - ✔✔charged a higher rate or denied coverage if a consumer qualifies for guaranteed issue, the insurance company CANNOT - ✔✔deny the consumers application apply pre-existing condition exclusions charge the consumer more due to past or present health problems The consumer must submit proper documentation with the enrollment application to prove guaranteed - ✔✔issue eligiblity EX: termination notice from prior coverage do guaranteed issue vary by state? - ✔✔yes it does consumers who are voluntarily switching from one med sup insurance company to another are generally NOT_______ - ✔✔entitled to guaranteed issue key reasons consumers choose ed sup insurance are: - ✔✔1) to be able to choose any doctor that accepts original medicare 2) to have predictable OOP costs 3) to have coverage when traveling within the US medicare open enrollment and guaranteed issue to med sups insurance plans - ✔✔1) med sup open enrollment is the first 6 months a consumer is 65 or older and enrolled in part B 2) during med sup open enrollment an insurer must offer the consumer any plan it sells 3) there are federal and state requirements for guaranteed issue and open enrollment 4) some states have additional med sup open enrollment periods 5) consumers have guaranteed issue and med sup open enrollment rights under federal and state law generally, consumers who drop another company's med sup are not eligible for guaranteed issue - ✔✔true during med sup open enrollment, can a consumer can be charged more because of present or past health conditions - ✔✔no they cannot AARP med sup insurance plans are insured by - ✔✔UHC insurance company ( UHC insurance company of NY for NY residents) - avail nationwide inc. washington dc and some us territories stable annual rate increases averaging 2.6% nationally between 2012 and 2016 -9/10 innsured members surveyed would recommend their AARP med sup plan to a friend of family member -96%member satisfaction rate of those surveyed with AARP med sup insirance plans -discounts are avail in most states the only med sup insurance plan that carry the AARP name - ✔✔AARP membership is required ( can enroll in aarp at the time of application to meet this requirement) available AARP med sup insurance plans are: - ✔✔Plans A,B,C,F,G,K,L,N medicare select plans C and F are available in some states to help apply for AARP membership med sup plans, you can use - ✔✔LEAN AARP vision discounts are provided by - ✔✔eyemed participating provides inc: lenscrafters, sears optical, jc penny optical, target optical, and pearle vision AARP med sup insured members receive slightly greater discounts for routine eye exams than - ✔✔AARP members AARP med sup plans have these additional services - ✔✔24 hr nurse healthline health and wellness programs and access to gym memberships in some states ( provided by Optumhealth) members also have access to an audio library with recorded messages on a large number of health and wellness topics) medicare select plans C and F are available in how many states - ✔✔19 states silversneakers fitness program is available only in - ✔✔certain states all AARP med sup insurance plans are available to consumers age 65 and older who qualify for - ✔✔guaranteed issue consumers who switch from a MAP to a med SUP insurance plan are SOMETIMES but not always entitled to - ✔✔guaranteed issue AARP med sup plan insured members can receive additional services at - ✔✔no additional cost agents are NOT permitted to discuss value added services in - ✔✔KS and NY until after enrollment select plans C and F provide the same benefits as plans - ✔✔C and F Members are required to use a network hospital for coverage of inpatient hospital services except in an - ✔✔emergency waiver state plans - ✔✔Massachusetts, Minnesota and Wisconsin are known as waiver states. These states are permitted by statue to offer their own standardized med sup plans. AARP medicare supplement insurance plans are available nationwide - ✔✔true One of the value added services available to AARP medicare sup plan insured members is financial counseling - ✔✔false AARP medicare select plans C and F are currently available in 19 states - ✔✔true You can find state specific information in the AARP medicare sup producer handbook - ✔✔true detailed specific info about AARP med sup insurance plans rates, underwritting, medicare supp open enrollment and guaranteed issue guidelines can be found in the producer handbook there are 2 rating methodologies used for AARP sup insurance plans. What are they - ✔✔Community rating and entry age rating What is the community rating - ✔✔its when insured members in the some rating class pay the same rate ( excludes discounts) note: in many states the use of tobacco products also determines the rate what is entry age rating - ✔✔its when rates are based on the members age as of his or her plan effective date do consumers who meet medicare supplement open enrollment or guaranteed issue requirements do not have to answer - ✔✔underwriting questions 0 to 7 months time since 65th birthday or medicare part B effective date will NOT have - ✔✔underwriting in the med sup open enrollment period if its been more than 7 months time since 65th birthday or medicare part B effective date will - ✔✔consumers who do not meed guaranteed issue requirements must answer health questions to determine their eligibility and rate. consumers who have any of the medical conditions listed on the application will pay a higher rate applicants who do not qualify for open enrollment or guaranteed issue will be underwritten and denied coverage for any of the following reasons - ✔✔1) told by a medical professional that they have end stage renal disease (ESRD) or they they require dialysis 2) hospitalized as an inpatient within the past 90 days( not including overnight outpatient observation) 3) Currently being treated or living in any type of nursing facility other than an assisted living facility applicants who do not qualify for open enrollment or guaranteed issue will be underwritten and denied coverage for any of the following reasons: - ✔✔within the past 2 years, told by a medical professional that they may need any of the following that has not been completed 1) hospital admittance as an inpatient 2) joint replacement 3) organ transplant 4)Surgery for cancer 5) back or spine surgery 6) Heart or vascular surgery consumers in 6 states( CA, FL, ME, MN, OR, and WA) must answer additional eligibility questions on the - ✔✔enrollment application Medical conditions that may cause a higher rate are: - ✔✔1) artery or vein bloackage 2) PVD 3) CHF 4) CAD 5) cancer inc melanoma, leukemia, lympoma 6)COPD, emphysema 7) Chronic kidney disease (CKD) 8) diabetes, but only with circulatory problems or retinopathy 9) Cirrhosis of liver 10) heart attack 11) Stroke, TIA consumers are eligible for the enrollment discount if their age on their plan effective date is - ✔✔65-74 OR 65-76 and their plan effective date is less than 10 years from their Medicare part B effective date Consumers are not eligible for the enrollment discount if they are - ✔✔age 77 or older underwritten and have a medical condition that qualifies for a level 2 rate if applicants are eligible for the enrollment discount, the discount percentage is applied to the - ✔✔standard rate. 1) the first year discount percentage and the duration of the discount program will vary based on the applicant's age as of the plan effective date 2) the discount percentage reduces 3% ea year on the anniversary date of the applicant's plan until the discount runs out 3) After the discount expires, applicants will pay the standard rate in most states, consumers who have smoked tobacco cigarettes or used any tobacco product at any time within the past 12 mothes will pay the - ✔✔tobacco rate in some states, tobacco use ratings does not apply to the consumers who meet - ✔✔medicares supplement open enrollment or guaranteed issue requirements in many states AARP medicare supplement plans are required to be offered to consumers who are - ✔✔under age 65 and eligible for medicare and who apply during an open enrollment or guarantee issue period in a limited number of states, consumers under age 65 and eligible for medicare who have: 1) ESRD are not eligible to apply ( even during open enrollment or guaranteed issue period) OR who apply outside of open enrollment or guaranteed issue periods: in many states AARP medicare supplement plans are required to be offered to consumers and must be at least - ✔✔50 years of age as required under the group master policy true statements: - ✔✔1) in states with entry age rating, the members age on their plan effective date is used to determine their rate 2) Consumers age 77 or older who are not eligible for the enrollment discount 3) The enrollment discount consumers receive in their first year of coverage depends on their age on their plan effective date 4) Consumers who are switching from one med sup plan carrier to another are generally not entitled to guaranteed issue and may need to answer health questions [Show More]

Last updated: 11 months ago

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