Module 2

Module 2-Medicare Health Plans 1. Module 2-Medicare Health Plans 1.1 Part C and other Medicare Health Plans

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1.2 Navigation Instructions

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1.3 Terms and Conditions

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1.4 LEARNING OBJECTIVES

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1.5 Training Roadmap: Part 2

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1.6 Part C: Medicare Advantage Plans

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1.7 Medicare Advantage Plans: Premiums

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1.8 Part C: Medicare Advantage Plan Benefits

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1.9 Medicare Advantage Plan- Utilization Management

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1.10 Medicare Advantage Eligibility

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1.11 Medicare Advantage Eligibility, continued

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1.12 Individuals with ESRD Beginning in 2021

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1.13 Medicare Advantage Eligibility, SNPs

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1.14 Medicare Advantage Eligibility: SNP Description

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1.15 Medicare Advantage Eligibility: EGWPs

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1.16 Medicare Advantage Eligibility, continued: MSAs

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1.17 Medicare Advantage Eligibility, Example

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1.18 MA Plan Types Coordinated Care Plans

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1.19 MA Plan Types Coordinated Care Plans - HMOs

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1.20 MA Plan Types Coordinated Care Plans - HMOs, continued

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1.21 MA Plan Types Coordinated Care Plans - PPOs

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1.22 MA Plan Types Private Fee-for-Service (PFFS) Plans

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1.23 MA Plan Types Private Fee-for-Service (PFFS) Plans

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1.24 MA Plan Types Private Fee-for-Service Plans, (2 of 3)

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1.25 MA Plan Types Private Fee-for-Service Plans, (3 of 3)

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1.26 MA Plan Types Medicare Savings Account Plans

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1.27 MA Plan Types Medical Savings Account (MSA) Plans

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1.28 MA Plan Types: MSA Plans, continued

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1.29 Medicare Advantage Employer/Union Plans

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1.30 Employer/Union Plans

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1.31 Medicare: Cost Plans

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1.32 Medicare Cost Plans

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1.33 Medicare Cost Plans: Network and Out-of-Network Care

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1.34 Medicare Cost Plans, Eligibility

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1.35 Medicare Cost Plans, Continued

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1.36 Medicare Advantage Plans and Dual Eligible Beneficiaries

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1.37 MA Plans and Dual Eligible Beneficiaries

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1.38 MA Plans and Dual Eligible Beneficiaries, continued

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1.39 MA Plans and Dual Eligible Beneficiaries, Important Issues

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1.40 Case Study

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1.41 Medicare Advantage and Prescription Drugs

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1.42 MA & Prescription Drugs

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1.43 MA & Prescription Drugs, continued

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1.44 MA & Prescription Drugs, Example

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1.45 Enrollee Protections Appeals and Grievances

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1.46 Enrollee Protections

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1.47 Enrollee Protections: Complaints, Coverage Decisions, Appeals

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1.48 Enrollee Protections: Grievances

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1.49 Enrollee Protections: Coverage Decisions

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1.50 Enrollee Protections: Appeals

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1.51 Enrollee Protections: Appeals, continued

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1.52 Enrollee Protections Network Requirements and Other Enrollee Rights

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1.53 Enrollee Protections: Network Requirements

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1.54 Enrollee Protections: Network Requirements, continued

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1.55 Enrollee Protections: Other Enrollee Rights

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1.56 Sources of Additional Information

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1.57 THANK YOU

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