View a complete list of the legal entities that offer, underwrite, administer or insure insurance products and services. Talk to your doctor about your risks and which test and schedule is right for you. What can he do according to CMS? Mr. Sampson tells Agent Ted that he is familiar with. He enrolled into Part B after the expiration of his IEP. Agent James is enrolling a prospect into a Humana Medicare Advantage plan and it is time to choose a PCP. covers a test to see if you have coronavirus (officially called coronavirus disease 2019 or COVID-19). Initial Coverage Enrollment Period (ICEP) can be used to enroll beneficiaries into which plans? Use Humana's Physician Finder Plus to see if the provider is in Humana's network. When it comes to Dual Eligible SNPs, it is imperative the dual eligible beneficiary is aware of ... All plans available in their area emphasizing those plans that best meet the beneficiary's needs. Our successful … Agent Martha can enter Mr. Simpson`s old Medicare ID number on the application since Humana will accept both the old and new Medicare ID numbers on applications through 2019. once per year). Agent Juan should advise Mrs. Maples that she will need to select another PCP since Dr. Grayson is not listed as an in-network provider. Use Humana's RX look up tools to determine if a medication is on Humana's formulary. Agents cannot use the ICEP election to enroll into a PDP. The agent clicks the test submit button or the test timer reaches 35 minutes. Which of the following was identified as a top reason for Humana agent complaints in PY17? Note: questions about passing the final exam are only in this practice exam. Agent Anna is not licensed in Nebraska. No. For details on … To avoid a lapse in coverage, the beneficiary must enroll on or before the last day of the month of the move. There are 13 new CLIA-waived tests effective April 1, 2019. Jan. 1, 2019, Part B Step Therapy Preferred Drug List – English, PDF opens in new window. The applications will be denied and marked for investigation. Individuals with a family history of certain diseases and those with other risk factors should discuss preventive health measures with their primary care doctor. How will Humana handle applications received during Pre-AEP? Advise Mrs. Maples that she will need to select another PCP since Dr. Grayson is not listed as an in-network provider. Carol is speaking with Agent Tomas. Why is it important for agents to offer guidance for provider selection? Select the statement below that best completes the following sentence. Before completing the enrollment, agents should take the time to perform a thorough review all features and benefits of the plan and make them understandable to the beneficiary, Agents should encourage members to ​receive their plan documentation digitally at the time of enrollment. A new PCP is selected. The annual OEP is available January 1st - March 31s. CMS expects agents to provide a clear, concise explanation of the plan's drug benefit. Texas residents insured by Humana Insurance Company. Which of the following actions can help agents avoid complaints about Benefits and Presentation? Visit for 24 hour access to information like claims history, eligibility, and Humana’s drug list. The premium payment option that was selected for the base MA/MAPD plan will be used to pay the monthly OSB plan premium. Agent Grace is enrolling Lamar into a Humana Medicare Advantage plan and asks him if his phone number is a. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 … Asking the beneficiary to consult with their doctor or pharmacist to obtain generic medications that are covered on the formulary. Agent Deborah must explain in and out of network benefits and any possible Independent Provider Association (IPA) affiliations of their selected PCP. What are the dates for the SEP for Non-Renewal? Exam should include measuring your weight, height, and body mass index (BMI). To be compliant with state and local regulations, what change will Humana Pharmacy members see to their. Which of the following statements is true regarding the Primary Care Provider (PCP) Change form? Because the FCC requires prior express written consent to contact a prospect or member via their cell phone. We also … How should you respond to Doris? If you have cardiovascular problems or diabetes, you may need a test every year. This plan includes additional Medicare prescription drug (Part-D) coverage. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 … You can expect your refills to arrive 5 to 7 days after placing your order. In which of the following situations is it acceptable for an agent to use their own email address for an applicant? She tells Agent Sarah that she would like to enroll in a MA-only (no RX). Is this acceptable? Which of the following is an advantage for new members when they pre-register with Humana Pharmacy? Agent move notification letters sent to members and prior members. Choose the answer that best explains the Telephonic Presentations policy. Agent Todd is completing an HMO enrollment with Mrs. Valdez and she asks if she can select Dr. Ayers as her PCP. Medical Plans. Call 1 … Exams include a digital rectal exam and a prostate-specific antigen test (PSA). Agents should advise beneficiaries that they need to respond promptly to Humana's request for Creditable Coverage, if applicable. Which of the following is considered marketing material and requires CMS approval? Eye exams for glaucoma and macular degeneration—to common age-related conditions. Which enrollment period should Agent Sarah select for Tamara`s application? The Telephonic Presentations policy provides guidance for licensed, appointed and certified sales agents representing a Humana Medicare Advantage (MA), in a non-call center setting, to perform a compliant telephonic Medicare sales presentation, Fill-in the blank: For events advertised to the general public, a Scope of Appointment (SOA) is, For events advertised to the general public, a Scope of Appointment (SOA) is not required, as the advertisement serves as a collective SOA. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker. Applicable tax or taxes will be applied to all applicable prescription orders. LOUISVILLE, Ky.--(BUSINESS WIRE)--Jul. It is never acceptable under any circumstance for an agent to complete the AOA application on behalf of their client, even if they request it. Go365 rewards up to $300 per member per year in redeemable gift cards for completion of preventive screenings and participation in healthy habits. In your form, you will need to explain your rationale for making this request, including a clinical justification and referencing any relevant lab test results. Agent Ben knows that Dr. Mendez is in network for a PPO plan in a particular service area. Agents can assist members requesting a PCP change and take action on their behalf. Doris has an SEP from her permanent move to Los Angeles. For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. Is there a difference in length between the Telephonic Presentation and the in-person presentation? Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations and terms under which the coverage may be continued in force or discontinued. Before applying for group coverage, please refer to the pre-enrollment disclosures for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage. Agent Todd can't. She is requesting to enroll in a Humana Medicare Advantage plan today. To assist enrollees and members in making an informed decision about providers that help members achieve the best possible health outcomes. Oscar delayed his Part B when he was first eligible. Talk to your doctor about your physical activity. Carol is speaking with Agent Tomas. Fill in the blank. Agent Deborah is enrolling a beneficiary into a Humana Medicare Advantage plan. Which enrollment period should Agent Wayne select for Oscar's application? ​To be compliant with state and local regulations, what change could Humana Pharmacy members see to their prescription costs? Many Humana Gold Choice Plans combine all the benefits of Original Medicare with prescription drug coverage and more.-Affordable monthly plan premium 40 coverage for most annual screenings.-Humana … Preventive care keeps you healthy, prevents illness and detects disease in the early stages –when it’s easier to treat. 1 Fact Sheet - 2020 Part C and D Star Ratings Note: The information included in this Fact Sheet is based on the 2020 Star Ratings published on the Medicare Plan Finder on October 9, 2019. When enrolling a member into an Optional Supplement Benefit (OSB), what should agents be sure to tell the member about the premium payment method? From October 15 to December 7, which election periods may be used? To inform people about their ability to receive information in another language and give directions on how to file a complaint should they feel they have been discriminated against, Individuals who belong to a qualified State Pharmaceutical Assistance Program (SPAP) are eligible for an SEP to, Make one enrollment request (both MAPD and PDP) at any time through the end of each calendar year (i.e. No, because agents may never suggest that a provider is or may be joining Humana's network. How you sleep, eat, and relax can impact your skin. What enrollment period will he use? When is the Medicare Advantage Disenrollment Period?

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