humana 1 test 2019

MA enrollees using the Medicare Advantage Disenrollment Period (MADP) to disenroll from their MA plan are eligible for a SEP to enroll in... How many questions are on Humana`s final exam and what material do they test on? Mr. Sampson tells Agent Ted that he is familiar with. Tell Mrs. Valez that Dr. Ayers is not listed as an in-network provider and request that she select another in-network PCP. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker. Asking the beneficiary to consult with their doctor or pharmacist to obtain generic medications that are covered on the formulary. Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). No, a provider may be contracted for one plan type but not another. To assist enrollees and members in making an informed decision about providers that help members achieve the best possible health outcomes. Agents must ensure that members understand how their plan's drug benefits, including important benefits such as drug tier information. once per year. When enrolling a beneficiary into a plan with prescription drug coverage, which of the following should agents do to avoid issues with any applicable Late Enrollment Penalty? Agent Juan is enrolling Mrs. Maples into a HMO plan. View a complete list of the legal entities that offer, underwrite, administer or insure insurance products and services. CMS expects agents to provide a clear, concise explanation of the plan's drug benefit. She asks you if she can enroll in a stand-alone PDP, instead. On-site pharmacy information. Talk to your doctor about your risks and which Pap testing schedule is best, especially if you’ve had a hysterectomy or are 65 or older. Visit Humana.com for 24 hour access to information like claims history, eligibility, and Humanaâs drug list. Exams include a digital rectal exam and a prostate-specific antigen test (PSA). Agent Anna is not licensed in Nebraska. He currently has a MAPD plan with ACME Co. and wants to enroll in a CarePlus MAPD plan. Use Humana's RX look up tools to determine if a medication is on Humana's formulary. No, because agents will use only Humana and CMS or State approved materials/scripts, as applicable, to market to prospective enrollees. He should explain that a full presentation of benefits is important and that it is a required for every enrollment. Agent Nicky conducts educational events at Dr. Singh`s office throughout the year. Dr. Grayson is part of the American Medical Group. Jan. 1, 2019, Commercial Preauthorization and Notification List â English, PDF opens in new window. The agent should use the exact same Medicare ID number and election period for both applications so that CMS can process the applications together and label them as spousal enrollments. Talk to your child’s doctor about the vaccine, which protects against cancers caused by HPV infection. Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. Note: questions about passing the final exam are only in this practice exam. Agents must have a valid resident or non-resident license and any required appointments issued from a state where the Medicare beneficiary permanently resides in order to market or sell a Humana MA and/or PDP plan. Do you qualify for Extra Help with Medicare costs? Learn how to keep it looking youthful. Individuals with a family history of certain diseases and those with other risk factors should discuss preventive health measures with their primary care doctor. The premium payment option that was selected for the base MA/MAPD plan will be used to pay the monthly OSB plan premium. How should Agent Juan handle this situation? Who is responsible for all applicable insurance licenses and any applicable certifications required to sell a corresponding Humana product in all states in which the agent markets such products? Our promise is to provide more than health insurance plans. When enrolling a member into an Optional Supplement Benefit (OSB), what should agents be sure to tell the member about the premium payment method? By submitting this form, the pharmacist may be able to have the medication covered by Humana. The dates for the SEP for Non-Renewal are December 8 - end of February. It is October 2nd and you, the agent, are speaking with Doris. Explain that his only opportunity to make a plan change is during the Annual Election Period (AEP). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. Yes, you can live to 100! Agents may provide guidance to members about providers who excel at value-based care that could improve member health outcomes. How can agents help Humana members receive less mail and have convenient, on-line access to plan documentation? Preventive care keeps you healthy, prevents illness and detects disease in the early stages –when it’s easier to treat. Mrs. Maples wants to select Dr. Grayson as her PCP. These services may be covered at no out of pocket cost to you when you visit a PCP in your health plan’s network. Oscar delayed his Part B when he was first eligible. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 â¦ Doris has an SEP from her permanent move to Los Angeles. He is only licensed in Montana. Which of the following actions should be avoided when completing spousal enrollments? View plan provisions or check with your sales representative. Limitations and exclusions. What are the dates for the SEP for Non-Renewal? Which of the following statements is true regarding the Primary Care Provider (PCP) Change form? How you sleep, eat, and relax can impact your skin. In which of the following situations is it acceptable to create an Email address for a beneficiary? Talk to your doctor about clinical breast exams. From October 15 to December 7, which election periods may be used? 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. Agent Deborah must explain in and out of network benefits and any possible Independent Provider Association (IPA) affiliations of their selected PCP. Initial Coverage Enrollment Period (ICEP) can be used to enroll beneficiaries into which plans? She recently picked up a second job working at Dr. Singh`s office on nights and weekends. When can agents begin marketing to non-renewing members? When a member selects a PCP when enrolling into a plan, what must agents explain about their PCP? Carol is speaking with Agent Tomas. Submit by fax to 1-888-447-3430 Submit by telephone at 1-866-461-7273 All Humana MA Members: For procedures or services that are investigational, experimental or may have limited benefit coverage, or for questions regarding whether Humana â¦ Test Interpretation and Feedback Previously, BrainCheck â¦ If you have cardiovascular problems or diabetes, you may need a test every year. Tell him that he has the Open Enrollment Period (OEP) available and proceed with the enrollment. 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 â¦ Is this acceptable? The HumanaChoice H5216-043 (PPOâ¦ LOUISVILLE, Ky.--(BUSINESS WIRE)--Jul. Your costs in Original Medicare You pay nothing for this test when you get it from a laboratory, pharmacy, doctor , or hospital, and when Medicare covers this test â¦ There you can also use the physician finder and get health news and information. You can expect your refills to arrive 5 to 7 days after placing your order. select an automated payment method to pay their monthly premium. Saturday, from 8 a.m. to 6:30 p.m. Eastern time. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits). Which of the following actions can help agents avoid complaints about Benefits and Presentation? Agents are responsible for all applicable insurance licenses and any applicable certifications required to sell a corresponding Humana product in all states in which the agent markets such products, ICEP is for enrollment into MA/MAPD only. 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. Agent Mike is speaking with Betty Ann and she is asking how to determine if her medication is covered by Part B or Part D. What is the preferred way for Agent Mike to determine if a medication is on Humana's formulary? Mrs. Maples wants to select Dr. Grayson as her PCP. What enrollment period will he use? Agent Juan cannot locate Dr. Grayson in Physician Finder but he did see that American Medical Group is listed as in-network. The MA/MAPD enrollment request is made prior to the Part B effective date. 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. This communication provides a general description of certain identified â¦ Find budget-friendly plans for your company’s most valuable asset: your employees. Carol is speaking with Agent Tomas. If your doctor feels there is no other covered option, he or she can call Humana Pharmacy Clinical Review at 1-800-555-2546 to ask for an exception. The following links are intended to facilitate documentation and coding diagnoses and services that are provided to patients with Humana â¦ Carol delayed Part B and wants to enroll in a Humana MA plan (No RX). Which of the following is an advantage for new members when they pre-register with Humana Pharmacy? Can agents create their own Medicare marketing materials, such as letters and flyers? If you have diabetes, these tests are recommended yearly: HbA1c test, LDL cholesterol, kidney test and retinal or dilated eye exam, May need to be more often if you have high blood pressure or diabetes, Periodically as directed by doctor; around 65 years or older, May need frequent screening after a bone fracture or if you’re at high risk for osteoporosis, Every 2-4 years to age 64, then every 1-2 years after. once per year). Humana individual life insurance plans are offered in New York by Humana Insurance Company. The agent clicks the test submit button or the test timer reaches 35 minutes. To be compliant with state and local regulations, what change could Humana Pharmacy members see to their prescription costs? We also â¦ 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. The final exam consists of 20 questions over material in the Agent Guidance Reference Manual. 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. Agent Grace is enrolling Lamar into a Humana Medicare Advantage plan and asks him if his phone number is a. Agent Ben knows that Dr. Mendez is in network for a PPO plan in a particular service area. A new PCP is selected. ... locate Dr. Ayers using Humana's Physician Finder tool. How will Humana handle applications received during Pre-AEP? What is this called? It is January 15th and you are speaking with Mr. Green. HumanaChoice H5216-043 (PPO) H5216-043 is a 2019 Medicare Advantage or Medicare Part-C plan by Humana available to residents in Texas. Sales agents must conduct the sales presentation in its entirety for telephonic presentations. To be compliant with state and local regulations, what change could Humana Pharmacy members see to their prescription costs? Exam should include measuring your weight, height, and body mass index (BMI). Doris tells you that she moved to Los Angeles last month to be near her grandchildren. Agents can NOT perform AEP enrollments during the pre-AEP period, per CMS. 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. Review the agent guidance manual before making another attempt. Because the FCC requires prior express written consent to contact a prospect or member via their cell phone. This new code matches the administration of BrainCheck and should be used for most test administrations after January 1, 2019. SEP can only be used (if a valid SEP exists) because Carol has delayed Part B and is enrolling after Part B effective date. Which enrollment period should Agent Wayne select for Oscar's application? The flu vaccine protects against the influenza viruses that will be the most common during the upcoming flu season. Agent James is enrolling a prospect into a Humana Medicare Advantage plan and it is time to choose a PCP. Agent Chris did not pass the final exam on his first try. Get help and learn about using your benefits, how insurance works, and more. TTY users should call, 1 â¦ Humana is including this hearing aid benefit on certain Medicare Advantage plans offered for the 2017 plan year in select states. Your health care provider can also ask Humana to make an exception. 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. What should he do? It is unclear if the provider is in Humana's network. Not available with all Humana health plans. About Humana. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 â¦