Tier 4 Use with Original Medicare $682 Co- Pay (91 until) 1% National Average $435 Deductible (2020) Co- insurance Drug Plans $1408 Deductible in 2020 C Referrals Travel the World RX @ Physician Offices Prior Authorization Outpatient Therapy Specialist Primary Care Physician Out-of - Network One Card for Everything People with Certain Disabilities Step Therapy $9.10 Deductible Increase from 2019 M Premium Varies IRMAA ALL COST SNF Inpatient Care PPO Vision Coverage Late Enrollment Penalty $0 copay SNF (1-20) Limited Outpatient RX Drugs $0 Co- Insurance (1-60) Tier 3 $352 Co- Insurance (61-90) Red/Blue/ White Card Tier 2 Withdraw from RRB K 190 days Impatient (psych) HMO Ambulatory Services Higher Premiums Stand Alone RX plan F Accepted by all Providers $176 copay SNF (21-100) Red/Blue/ White Care 20% Co- insurance Home Health Care Networks HMO- POS Withdraw from Social Security Tier 1 $13.00 Beneficiary Deductible G $32.74 Late Enroll Premium L Fitness Benefit Dental Coverage N Formulary B Hospice Care In- Network Usually earned by working Covers 80% MA Services D $198 Beneficiary Deductible Durable Medical Equipment Tier 5 $0 Premium Plans Deductible Phase Copayment People With ESRD Hearing Coverage 65 or older Skilled Nursing Facility Flexible Network Quantity Limits Must be eligible for Part A No enrollment Period No Networks A $144.60 Deductible (2020) Tier 4 Use with Original Medicare $682 Co- Pay (91 until) 1% National Average $435 Deductible (2020) Co- insurance Drug Plans $1408 Deductible in 2020 C Referrals Travel the World RX @ Physician Offices Prior Authorization Outpatient Therapy Specialist Primary Care Physician Out-of - Network One Card for Everything People with Certain Disabilities Step Therapy $9.10 Deductible Increase from 2019 M Premium Varies IRMAA ALL COST SNF Inpatient Care PPO Vision Coverage Late Enrollment Penalty $0 copay SNF (1-20) Limited Outpatient RX Drugs $0 Co- Insurance (1-60) Tier 3 $352 Co- Insurance (61-90) Red/Blue/ White Card Tier 2 Withdraw from RRB K 190 days Impatient (psych) HMO Ambulatory Services Higher Premiums Stand Alone RX plan F Accepted by all Providers $176 copay SNF (21-100) Red/Blue/ White Care 20% Co- insurance Home Health Care Networks HMO- POS Withdraw from Social Security Tier 1 $13.00 Beneficiary Deductible G $32.74 Late Enroll Premium L Fitness Benefit Dental Coverage N Formulary B Hospice Care In- Network Usually earned by working Covers 80% MA Services D $198 Beneficiary Deductible Durable Medical Equipment Tier 5 $0 Premium Plans Deductible Phase Copayment People With ESRD Hearing Coverage 65 or older Skilled Nursing Facility Flexible Network Quantity Limits Must be eligible for Part A No enrollment Period No Networks A $144.60 Deductible (2020)
(Print) Use this randomly generated list as your call list when playing the game. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.
D-Tier 4
D-Use with Original Medicare
A-$682 Co-Pay
(91 until)
D-1% National
Average
D-$435
Deductible (2020)
D-Co-insurance
C-Drug Plans
A-$1408 Deductible in 2020
S-C
C-Referrals
S-Travel the World
B-RX @ Physician Offices
D-Prior
Authorization
B-Outpatient Therapy
C-Specialist
C-Primary Care Physician
C-Out-of -Network
C-One Card
for Everything
A-People with Certain Disabilities
D-Step Therapy
B-$9.10
Deductible Increase from 2019
S-M
D-Premium Varies
B-IRMAA
A-ALL COST
SNF
A-Inpatient Care
C-PPO
C-Vision Coverage
B-Late Enrollment Penalty
A-$0 copay SNF
(1-20)
B-Limited Outpatient
RX Drugs
A-$0 Co-Insurance
(1-60)
D-Tier 3
A-$352 Co-Insurance
(61-90)
B-Red/Blue/
White
Card
D-Tier 2
B-Withdraw from RRB
S-K
A-190 days Impatient (psych)
C-HMO
B-Ambulatory Services
S-Higher Premiums
S-Stand Alone
RX plan
S-F
S-Accepted by all Providers
A-$176 copay
SNF
(21-100)
A-Red/Blue/ White
Care
B-20% Co-insurance
A-Home Health Care
C-Networks
C-HMO-POS
B-Withdraw from Social Security
D-Tier 1
B-$13.00 Beneficiary Deductible
S-G
D-$32.74
Late Enroll
Premium
S-L
C-Fitness Benefit
C-Dental
Coverage
S-N
D-Formulary
S-B
A-Hospice Care
C-In-Network
A-Usually earned by working
B-Covers 80% MA
Services
S-D
B-$198 Beneficiary
Deductible
B-Durable Medical Equipment
D-Tier 5
C-$0
Premium
Plans
D-Deductible Phase
D-Copayment
A-People With ESRD
C-Hearing
Coverage
A-65 or older
A-Skilled Nursing Facility
S-Flexible Network
D-Quantity Limits
B-Must be eligible for Part A
S-No enrollment Period
S-No Networks
S-A
B-$144.60
Deductible
(2020)