Insurance Benefits Outside the US

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What should the Agent inquire about after reviewing additional benefits with the beneficiary?

The provider network status of the plan

Whether the beneficiary is interested in reviewing other benefits (correct)

The beneficiary's medical history

The cancellation policy of the enrollment

What should the Agent review with the beneficiary during the enrollment process?

The provider network status of the plan

The pharmacy network status of the plan

Dental, Vision, and Hearing benefits (correct)

The beneficiary's income level

What is a requirement for the Agent during the enrollment process?

To answer all additional questions asked by the applicant or their legal representative (correct)

To review the plan's network status

To provide the beneficiary with a list of providers

To provide the beneficiary with a hard copy of the EOC

What should the Agent offer to review with the beneficiary during the enrollment process?

The provider network status, current prescriptions, hospital network status, and facility network status Signup and view all the answers

What is a resource available to the Agent during the enrollment process?

A Job Aid: DMS 214 Medicare Presentation of Benefits Page 14 Signup and view all the answers

What is the PCP copayment in the described plan?

$5 Signup and view all the answers

What should the agent do if Humana is not the best plan for the consumer?

Explain the reasoning and suggest alternative options Signup and view all the answers

What is the purpose of recapping the important benefits with the beneficiary?

To reiterate why the Humana plan is a good choice Signup and view all the answers

How should the agent engage the beneficiary during the plan presentation?

Speak clearly and pause to gauge understanding Signup and view all the answers

What is the primary goal of the agent during the plan presentation?

To portray Humana and its partners in a positive light Signup and view all the answers

Why should the agent ask the beneficiary to recap their reasons for choosing Humana?

To ensure the beneficiary understands the plan benefits Signup and view all the answers

What is the purpose of 42 CFR § 422.111(a),(b) in regards to MA organizations?

To require MA organizations to disclose information in clear, accurate, and standardized form Signup and view all the answers

What is required to be reviewed during telephonic enrollments according to 42 CFR § 422.2267(e)(4)?

The PECL, including EOC, providers, medications, premiums, and plan-type rules Signup and view all the answers

What is the purpose of 42 CFR § 422.2274(c)(9)(i) in regards to MA organizations?

To require MA organizations to establish a system for confirming beneficiary understanding of the product Signup and view all the answers

What is required to be explained to beneficiaries according to the approved script requirement?

All of the above, plus maximum out-of-pocket responsibility and preventive care examples Signup and view all the answers

What is required to be reviewed by MA organizations according to 42 CFR § 422.2264(c)(3)(ii)(D)?

The individual's health care needs, history, and commonly used medications Signup and view all the answers

What is the purpose of 42 CFR § 422.2262(a)(1)(i),(iii) in regards to MA organizations?

To prohibit MA organizations from engaging in activities that mislead or confuse beneficiaries Signup and view all the answers

Insurance Benefits Outside the US

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