ANOC/EOC Crossword

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Across
  1. 2. The periodic payment to Medicare, an insurance company, or a health care plan for health and/or prescription drug coverage
  2. 5. The doctor or other provider you see first for most health problems (abbreviation)
  3. 6. The Medicare ___________ Gap Discount Program provides manufacturer discounts on brand-name drugs to Part D enrollees
  4. 8. State program that offers free counseling about Medicare (abbreviation)
  5. 9. Our contract with you (abbreviation)
  6. 11. A department, within our plan, responsible for answering your questions about your membership, benefits, grievances and appeals (two words)
  7. 16. A Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, such as premiums, deductibles and coinsurance (two words)
  8. 20. What you pay if your income is greater than $85,000 for an individual or greater than $170,000 for married couples for your Medicare Part D coverage (abbreviation)
  9. 21. The official name for a complaint you can file with your plan
  10. 23. In order to be ________ for our plan, you must be entitled to Medicare Part A and enrolled in Medicare Part B
  11. 24. Customer Service has free language _________ services available for non-English speakers
  12. 25. Medicare _________ generally helps cover services provided by hospitals (for inpatient services, skilled nursing facilities or home health agencies)
  13. 26. An amount you may be required to pay as your share of the cost for services or prescription drugs, usually a percentage
  14. 28. Annual _______ Period, October 15 until December 7
Down
  1. 1. A ________ pharmacy is a pharmacy that contracts with our plan where members can get their prescription drug benefits
  2. 3. The limit to how much you have to pay each year for in-network medical services (abbreviation)
  3. 4. The general term we use for doctors, other health care professionals, hospitals and other health care facilities
  4. 7. Generally, a _________ drug works the same as a brand-name drug and usually costs less
  5. 10. Approval in advance to get services or certain drugs that may or may not be on our formulary (two words)
  6. 11. An amount you may be required to pay as your share of the cost for a medical service or supply, a set dollar amount
  7. 12. The Federal health insurance program for people 65 years of age or older, some people under age 65 with certain disabilities and people with end-stage renal disease
  8. 13. A joint Federal and state program that helps with medical costs for some people with low incomes and limited resources.
  9. 14. The most current Provider/Pharmacy Directory and Formulary can be found on our ________
  10. 15. The list of covered drugs or “Drug List”
  11. 17. A geographic area where a health plan accepts members if it limits membership based on where people live (two words)
  12. 18. Every drug on the List of Covered Drugs is in a cost-sharing _____
  13. 19. We send you a monthly report called the “Part D _______ of Benefits”
  14. 22. Situations in which you may be eligible for a ______ Enrollment Period include if you move outside the service area
  15. 25. Medicare _________ is for most other medical services (such as physicians’ services and other outpatient services) and certain items (such as durable medical equipment and supplies)
  16. 27. Describes the year over year changes to your plan (abbreviation)