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