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AEP - Annual Election Period (Nov 15 thru Dec 31) (new enrollees, change plans, penalty for late after ICEP)
ANOC - Annual Notice of Change (in Oct)
BRC - Business Reply Card
CHF - Congestive Heart Failure
CMS - Center for Medicare & Medicaid Services (http://www.cms.hhs.gov)
COB - Coordination of Benefits
COPD - Chronic Obstructive Pulmonary Disease
CVD - Cardio Vascular Disease
Dementia includes Alzheimers and Parkinsons
DH - Dual HMO
DME - Durable Medical Equipment
DP - Dual PPO
DSU - Distribution Support Unit is now PHD email phd...uhc.com phone 888-381-8581
Dual - Medicare & Medicaid (can change plans monthly)
EED - Early Enrollment Discount
EOC - Evidence of Coverage (after enrollment)
ESRD - End Stage Renal Disease includes Kidney Dialysis
ETF - Electronic Funds Transfer
FPL - Federal Poverty Level
HCFA - Health Care Financing Administration (previous name of CMS)
HHS - Health and Human Services (over CMS & medicare)
HMO - Health Maintenance Organization
HRA - Health Risk Assessment
Hypertension - High Blood Pressure
ICEP - Initial Coverage Election Period (disability or age in- turning 65, 3 months before & after birth month)
IEA - Individual Enrollment Application
Lock-In - Apr 1 thru Dec 31 (can add med supp anytime, special need can switch to ev once per life time)
LIS - Low Income Subsidy max Incomes for 2007 (Poverty Levels)
LIS application at SSA request Low Income Subsidy Application Form SSA-1020B or call 1-800-772-1213 or go to
    www.ssa.gov or TDD 1-800-325-0778
MA - Medicare Advantage plan
MA-HMO - Medicare Advantage HMO
MAC - Medicare Allowable Charge
MAPD - Medicare Advantage plan w/Presciption Drugs
Medicare - 1-800-MEDICARE or http://www.medicare.gov
MH - Multiple HMO
MMA - Medicare Modernization Act
MP - Multiple PPO
OEP - Open Enrollment Period (Jan 1 thru Mar 31) (cannot add/delete drug coverage, can change from orig medicare + pdp to mapd, can add ma during oep, can add med supp anytime, special need can switch to ev once per life time)
OEV - outbound education verification process
OOP - Out-of-Pocket
Part A - Hospitalization & SNF & Hospice
Part B - medical Doctors, providers & outpatient coverage
Part C - Medicare Advantage plans
Part D - Prescription Drug plan
PCP - Primary Care Physician
PDP - Prescription Drug Plans
PFFS - Private Fee for Service
POA - Power of Attorney
POS - Point of Service
PPO - Preferred Provider Organization
PSV - Post Sale Verification call
QMB - Qualified Medicare Beneficiaries
Rx - Pharmacy Drugs
SB - Summary of Benefits (pre-sale)
SEP - Special Election Period (move out of service area, into or out of SNF, loss of creditable group coverage)
SEP-MOVE - Special Election Period w/Move into new service area
SEP-SN - Special Election Period w/Special Needs
SNF - Skilled Nursing Facility (in part A)
SNP - Special Needs Plan (can change plans monthly)
SOB - Summary of Benefits (after enrollment)
SSA - Social Security Administration 1-800-778-1213 or www.ssa.gov/prescriptionhelp
SSC - Social Service Connection
SSI - Supplemental Security Income
TDD - Translation Devices for Deaf (current)
TOC - Transition of Care form.doc (for DME)
Total drug cost - what you pay + what the plan pays
TrOOP - True Out Of Pocket costs include copays, coinsurance, and the amounts you must pay in the coverage gap, does
    not include monthly premiums
TTY - Tele type Terminal (obsolete)
Tier 1 - Preferred Generics
Tier 2 - Preferred Brands
Tier 3 - Non-Preferred Brands, Generics
Tier 4 - Specialty drugs or cost over $500

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Chronic:
CHF - Congestive Heart Failure
COPD - Chronic Obstructive Pulmonary Disease
CVD - Cardio Vascular Disease
Diabetes
Dementia
Arthritis
Asthma
Hypertension

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Enrollment Kit required contents:
Application + Note to enrollees (enter my writing number)
Chronic illness pre-enrolment qualification assessment (chronic plan only)
Summary of Benefits
small brochure
personal care catalog sales flier
how much will I pay flier
grievances & appeals sheet
cover letter
benefit highlight card
return envelope (remove)

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Supporting collateral:
co-pay flier
leave behind flier

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agent briefcase items - do not hand out (they get it in welcome kit)
personal care catalog
formulary
provider directory
pharmacy directory
sales detailer/flipchart
company story

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CMS requirements for sales kits and presentation:
explain plan benefits and premiums
explain enrollment limitations & limited election periods
explain pharmacy network limitions (PDP only)
explain grievance, coverage determination & appeals processes
explain availability of alternative formats for materials (non-english, braille)

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