2023-2024 BCBS/HCSC | Quizlet

How many levels are in the Appeals Process for a member

5

True or False - For 2023 the HCSC/HISC Medicare Part C and D mail-order programs are administered by Alliance RX Walgreens Prime and ESI mail-order.

True

The Medicare Advantage Open Disenrollment Period is available ______.

January 1 to March 31

True or False - The Blue Cross MedicareRx product portfolio only consists of two plan designs Basic and Value.

False

For 2024, the Part D Initial Deductible is ______.

$545 in 2024.

True or False - For 2023, the Part D Initial Coverage Limit is $3,820?

False

True or False - For 2024, Part D enrollees will no longer have any cost sharing in the catastrophic phase?

True

True or False - Medicare beneficiaries may join Blue Cross Medicare Advantage if they are entitled to Medicare Part A, enrolled in Medicare Part B, and live in the service area?

True

At a marketing/sales event, producers and the Plan Sponsor may do all except the following:

Providing testimonials

True or False - Dual Eligible Special Needs Plans (D-SNPs) enroll beneficiaries who are entitled to both Medicare (Title XVIII) and Medical Assistance from a State Plan under Title XIX (Medicaid)?

True

True of False - Blue Access Producers is an online resource that provides producers with instant access to the tools and information needed to build a stronger business and better service clients.

True

Tier ____ consists of specialty drugs that are high-cost medications such as injectable antibiotics, biological agents, and chemotherapeutic agents.

True or False - A potential member's Initial Enrollment Period (IEP) is a 7-month period (This seven-month period begins three months before the 65th birthday, includes the month the member turns 65 and ends three months after they turn 65).?

True

True or False - A non-preferred network pharmacy is still considered a network pharmacy. However the reduced copay structure of the preferred network pharmacy program is not offered?

True

True of False - Walgreen's is a network pharmacy available in all 5 HCSC states?

True

The 3 types of preferred network pharmacies within the HCSC/HISC Medicare Part C and P plan networks are all except the following:

Out of Network Pharmacies

When enrolling a client into either a Blue Cross MedicareRX, Medicare Blue RX, or Blue Cross Medicare Advantage plan, agents should discuss all items except:

Plan Designs

True or False - The Out-of-Pocket Threshold (TROOP) for 2024 is $8k?

True

True or False - Members whom select the Social Security Administration (SSA) billing option should pay their premiums until the deductions begin in order to avoid plan disenrollment?

True

The Request for Information Process (RFI) allots the member ____ days to respond and provide the requested information to avoid the enrollment from being denied.

21

True or False - A sales agent may call customer service and request a billing option change without the client being on the phone?

False

The HCSC/HISC Medicare Part C and D mail-order program only offers a 30 day supply on all medications?

False

True or False - For 2023 the CMS Part D Initial Coverage Limit is $4,460?

False - it's $5,030

True or False - For 2024 the Blue Cross MedicareRX formulary is the same for the Value, Plus and Basic Plans?

False