TTY users should call, 1 … According to recent CMS guidance, which of the following plan changes is NOT allowed during the annual OEP? When enrolling a member into an Optional Supplement Benefit (OSB), what should agents be sure to tell the member about the premium payment method? The HumanaChoice H5216-043 (PPO… Exams include a digital rectal exam and a prostate-specific antigen test (PSA). Agents can NOT perform AEP enrollments during the pre-AEP period, per CMS. Mrs. Maples wants to select Dr. Grayson as her PCP. It is unclear if the provider is in Humana's network. This plan includes additional Medicare prescription drug (Part-D) coverage. Jan. 1, 2019, Part B Step Therapy Preferred Drug List – English, PDF opens in new window. Use Humana's Physician Finder Plus to see if the provider is in Humana's network. When is the annual Open Enrollment Period (OEP) available? In which of the following situations is it acceptable to create an Email address for a beneficiary? Humana individual vision plans are insured by Humana Insurance Company, The Dental Concern, Inc., or Humana Insurance Company of New York, or Humana Health Benefit Plan of Louisiana, Inc. Arizona residents insured by Humana Insurance Company. HumanaChoice H5216-043 (PPO) H5216-043 is a 2019 Medicare Advantage or Medicare Part-C plan by Humana available to residents in Texas. Review the Agent Guidance Reference Manual before making another attempt. To receive these preventive services, make an appointment with your doctor and bring this checklist to talk about which screenings you may need. What are the dates for the SEP for Non-Renewal? Agent Anna enrolled a prospect in a Humana MAPD plan for Nebraska. Nicky must be complete a new form within 30 days. Agent Chris did not pass the final exam on his first try. Doris has an SEP from her permanent move to Los Angeles. Yes, you can live to 100! Mr. Sampson tells Agent Ted that he is familiar with. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits). Do you qualify for Extra Help with Medicare costs? Tell him that he has the Open Enrollment Period (OEP) available and proceed with the enrollment. This communication provides a general description of certain identified … If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800-379-0092 (TTY: 711), Monday to Friday 8 a.m. to 11p.m. Agents can assist members requesting a PCP change and take action on their behalf. Limitations and exclusions. ... locate Dr. Ayers using Humana's Physician Finder tool. No central point to view all claims, each person has to sign up themselves. 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. 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. Test Interpretation and Feedback Previously, BrainCheck … Agents not using Humana's Physician Finder tool correctly. Talk to your doctor about your risks and which test and schedule is best for you; most recommend a yearly fecal occult blood test, a flexible sigmoidoscopy every five years, or a colonoscopy every 10 years. Agent Ted is completing an enrollment with Mr. Sampson. He wants to enroll all of them in Medicare Advantage Plans during AEP. Go365 rewards up to $300 per member per year in redeemable gift cards for completion of preventive screenings and participation in healthy habits. In which of the following situations is it acceptable for an agent to use their own email address for an applicant? What is this called? Humana Reports Fourth Quarter 2019 Financial Results; ... Net income was $2.7 billion for 2019 compared to $1.7 billion in 2018 and earnings per diluted common share increased $7.94 from $12.16 earnings per diluted common share in 2018 to $20.10 earnings per diluted common share in 2019. Why is it important for agents to offer guidance for provider selection? For dates of service beginning April 1, 2020, use the new code published by the CDC, as appropriate (New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), April 1… She tells Agent Sarah that she would like to enroll in a MA-only (no RX). He enrolled into Part B after the expiration of his IEP. Statements in languages other than English contained in the advertisement do not necessarily reflect the exact contents of the policy written in English, because of possible linguistic differences. Use Humana's RX look up tools to determine if a medication is on Humana's formulary. SEP can only be used (if a valid SEP exists) because Carol has delayed Part B and is enrolling after Part B effective date. Please contact our Customer Service number at 1 … Applicable tax or taxes will be applied to all applicable prescription orders. Which of the following is an advantage for new members when they pre-register with Humana Pharmacy? Explain that because she has called during the Medicare Advantage Disenrollment Period (MADP), she is eligible to disenroll from her current plan and enroll in a stand-alone PDP. Note: questions about passing the final exam are only in this practice exam. Individuals who belong to a qualified SPAP are eligible for an SEP to make one enrollment request at any time through the end of each calendar year (i.e. How should you respond to Doris? 99% of Humana members who terminate for non-payment of premium do not ___________________. Letters sent by agents to current and prior members announcing the agent has changed agencies. You can expect your refills to arrive 5 to 7 days after placing your order. 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. What must Agent Deborah explain about the new PCP? Humana legal entities that offer, underwrite, administer or insure insurance products and services, View a complete list of the legal entities. Why are agents required to ask if the phone number being provided on an application is a cell phone number? To be compliant with state and local regulations, what change could Humana Pharmacy members see to their prescription costs? It allows members to obtain pricing for medications based on their future effective date. No, because agents may never suggest that a provider is or may be joining Humana's network. When is the Medicare Advantage Disenrollment Period? 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? Which of the following is not an automated payment option for Humana Medicare enrollments? Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc. Humana group life plans are offered by Humana Insurance Company or Humana Insurance Company of Kentucky. How will Humana handle applications received during Pre-AEP? John is an agent who has older family members on Medicare and living in several different states. Taxes will be applied to all applicable prescription and over-the-counter (OTC) orders. View a complete list of the legal entities that offer, underwrite, administer or insure insurance products and services. Agent Ben knows that Dr. Mendez is in network for a PPO plan in a particular service area. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 … For dates of service prior to April 1, ... to have COVID-19, and the test results for the exposed individual are either unknown or negative. How you sleep, eat, and relax can impact your skin. He is only licensed in Montana. ​To be compliant with state and local regulations, what change could Humana Pharmacy members see to their prescription costs? The final exam consists of 20 questions over material in the Agent Guidance Reference Manual. 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). When a beneficiary moves out of a plan`s service area, when must they enroll into a plan servicing the new area to avoid a lapse in coverage? Agent Grace is enrolling Lamar into a Humana Medicare Advantage plan and asks him if his phone number is a. How can agents help reduce paper applications being denied due to improper election type code? Mrs. Maples wants to select Dr. Grayson as her PCP. He is meeting with Agent Wayne and Oscar is requesting to enroll in a Humana MAPD plan in the 3 months prior to his Part B effective date. Fill in the blank. Go365® is not an insurance product. Agents should read through the SEPs listed on page five of the paper application and select any that apply, It allows members to obtain pricing for medications based on their future effective date. Which of the following actions can help agents avoid complaints about Benefits and Presentation? How should Agent Juan handle this situation? 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 … Jan. 1, 2019, Commercial Preauthorization and Notification List – English, PDF opens in new window. What are the dates for the Special Election Period (SEP) for Non-Renewal? 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. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 … To avoid a lapse in coverage, the beneficiary must enroll on or before the last day of the month of the move. LOUISVILLE, Ky.--(BUSINESS WIRE)--Jul. Agent Deborah is enrolling a beneficiary into a Humana Medicare Advantage plan. 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 Nicky conducts educational events at Dr. Singh`s office throughout the year. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 … She is requesting to enroll in a Humana Medicare Advantage plan today. Agent Todd can't. Initial Coverage Enrollment Period (ICEP) can be used to enroll beneficiaries into which plans? Asking the beneficiary to consult with their doctor or pharmacist to obtain generic medications is not an acceptable explanation of the plan's drug benefit, What constitutes an "attempt" on Humana`s final exam? Texas residents insured by Humana Insurance Company. Of course, if a beneficiary has another valid election period (i.e., IEP, SEP) available during this time, enrollments can be completed. 1, 2019-- Humana Inc. (NYSE: HUM) will release its financial results for the second quarter 2019 (2Q19) on Wednesday, July 31, 2019 at 6:30 a.m. eastern time.The company will host a conference call at 9:00 a.m. eastern time that morning to discuss its financial results for the quarter and earnings guidance for 2019. Talk to your doctor about clinical breast exams. 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. Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state. Oscar delayed his Part B when he was first eligible. How would you respond to Mrs. Damon? Individuals with a family history of certain diseases and those with other risk factors should discuss preventive health measures with their primary care doctor. What should he do? 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 … Your health care provider can also ask Humana to make an exception. Advise Mrs. Maples that she will need to select another PCP since Dr. Grayson is not listed as an in-network provider. You can reach us during the following hours: Monday through Friday, from 8 a.m. to 11 p.m., Eastern time. 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. Ben tells Mary that he knows Dr. Mendez in network for Humana plans and does NOT check Humana`s Physician Finder Plus. Talk to your child’s doctor about the vaccine, which protects against cancers caused by HPV infection. If you’re newly-eligible or looking to switch plans, our Medicare plans include all-in-one Medicare Advantage plans, standalone Part D drug plans, and Medicare Supplement plans. Agent Juan cannot locate Dr. Grayson in Physician Finder but he did see that American Medical Group is listed as in-network. When enrolling Mary into an HMO plan for the same service area, Mary wants to select Dr. Mendez as her PCP. Which enrollment period can Agent Tomas use? Learn how to keep it looking youthful. covers a test to see if you have coronavirus (officially called coronavirus disease 2019 or COVID-19). Can agents create their own Medicare marketing materials, such as letters and flyers? Sales agents must conduct the sales presentation in its entirety for telephonic presentations. Agent Ben should have checked to see the provider was contracted for the HMO plan. However, he knows that Dr. Ayers is in-network for the Humana PPO plan in ... ID number on the application since Humana will accept both the old and new Medicare ID numbers on applications through 2019. Using 87804 x 2 might result in denial. Humana is including this hearing aid benefit on certain Medicare Advantage plans offered for the 2017 plan year in select states. 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? What enrollment period will he use? The purpose of the Non-Discrimination notice is 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. Doris tells you that she moved to Los Angeles last month to be near her grandchildren. Humana individual life insurance plans are offered in New York by Humana Insurance Company. Use Humana's Physician Finder Plus to see if the provider is in Humana's network. Fill-in the blank: For events advertised to the general public, a Scope of Appointment (SOA) is _________. Carol is speaking with Agent Tomas. When a member selects a PCP when enrolling into a plan, what must agents explain about their PCP? Exam should include measuring your weight, height, and body mass index (BMI). Preventive care keeps you healthy, prevents illness and detects disease in the early stages –when it’s easier to treat. Agents should advise beneficiaries that they need to respond promptly to Humana's request for Creditable Coverage, if applicable. You are speaking with Mrs. Damon on February 3rd and she is requesting to disenroll from the MA-only HMO plan. The dates for the SEP for Non-Renewal are December 8 - end of February. For detailed information about Humana’s claim payment inquiry process, review the claim payment inquiry process guide (300 KB)., PDF opens new window. Is there a difference in length between the Telephonic Presentation and the in-person presentation? Learn about enrolling in your employer plan and find resources and support to make the most of your benefits. If you shop at one of our Humana Pharmacy retail locations and have a question, we're here to help. 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. Tell Mrs. Valez that Dr. Ayers is not listed as an in-network provider and request that she select another in-network PCP. Which of the following statements best describes Go365? No, a provider may be contracted for one plan type but not another. Humana may terminate upon discovery and report incidences of submission of applications by unlicensed agents and brokers to the authority in the State where the application was submitted as well as to CMS.

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