$435 Deductible (2020) Out-of - Network RX @ Physician Offices Specialist 1% National Average $9.10 Deductible Increase from 2019 Stand Alone RX plan Must be eligible for Part A Late Enrollment Penalty Referrals Tier 3 Flexible Network No enrollment Period $1408 Deductible in 2020 Hospice Care Vision Coverage $0 copay SNF (1-20) Durable Medical Equipment M Outpatient Therapy Hearing Coverage F Home Health Care Ambulatory Services HMO- POS HMO $198 Beneficiary Deductible B Formulary $0 Premium Plans Skilled Nursing Facility People With ESRD K Tier 5 $144.60 Deductible (2020) 65 or older $352 Co- Insurance (61-90) Fitness Benefit Usually earned by working 20% Co- insurance Step Therapy D $682 Co- Pay (91 until) Quantity Limits Withdraw from Social Security Premium Varies Prior Authorization Primary Care Physician Copayment Red/Blue/ White Card A People with Certain Disabilities Co- insurance Inpatient Care IRMAA Deductible Phase One Card for Everything Accepted by all Providers $176 copay SNF (21-100) No Networks C Use with Original Medicare ALL COST SNF Tier 1 Cata- strophic Phase $32.74 Late Enroll Premium Red/Blue/ White Card N Must not have ESRD Travel the World $0 Co- Insurance (1-60) Dental Coverage L Higher Premiums Limited Outpatient RX Drugs Tier 2 In- Network Drug Plans Networks Tier 4 Covers 80% MA Services PPO G 190 days Impatient (psych) $13.00 Beneficiary Deductible Withdraw from RRB $435 Deductible (2020) Out-of - Network RX @ Physician Offices Specialist 1% National Average $9.10 Deductible Increase from 2019 Stand Alone RX plan Must be eligible for Part A Late Enrollment Penalty Referrals Tier 3 Flexible Network No enrollment Period $1408 Deductible in 2020 Hospice Care Vision Coverage $0 copay SNF (1-20) Durable Medical Equipment M Outpatient Therapy Hearing Coverage F Home Health Care Ambulatory Services HMO- POS HMO $198 Beneficiary Deductible B Formulary $0 Premium Plans Skilled Nursing Facility People With ESRD K Tier 5 $144.60 Deductible (2020) 65 or older $352 Co- Insurance (61-90) Fitness Benefit Usually earned by working 20% Co- insurance Step Therapy D $682 Co- Pay (91 until) Quantity Limits Withdraw from Social Security Premium Varies Prior Authorization Primary Care Physician Copayment Red/Blue/ White Card A People with Certain Disabilities Co- insurance Inpatient Care IRMAA Deductible Phase One Card for Everything Accepted by all Providers $176 copay SNF (21-100) No Networks C Use with Original Medicare ALL COST SNF Tier 1 Cata- strophic Phase $32.74 Late Enroll Premium Red/Blue/ White Card N Must not have ESRD Travel the World $0 Co- Insurance (1-60) Dental Coverage L Higher Premiums Limited Outpatient RX Drugs Tier 2 In- Network Drug Plans Networks Tier 4 Covers 80% MA Services PPO G 190 days Impatient (psych) $13.00 Beneficiary Deductible Withdraw from RRB
(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-$435
Deductible (2020)
C-Out-of -Network
B-RX @ Physician Offices
C-Specialist
D-1% National
Average
B-$9.10
Deductible Increase from 2019
S-Stand Alone
RX plan
B-Must be eligible for Part A
B-Late Enrollment Penalty
C-Referrals
D-Tier 3
S-Flexible Network
S-No enrollment Period
A-$1408 Deductible in 2020
A-Hospice Care
C-Vision Coverage
A-$0 copay SNF
(1-20)
B-Durable Medical Equipment
S-M
B-Outpatient Therapy
C-Hearing
Coverage
S-F
A-Home Health Care
B-Ambulatory Services
C-HMO-POS
C-HMO
B-$198 Beneficiary
Deductible
S-B
D-Formulary
C-$0
Premium
Plans
A-Skilled Nursing Facility
A-People With ESRD
S-K
D-Tier 5
B-$144.60
Deductible
(2020)
A-65 or older
A-$352 Co-Insurance
(61-90)
C-Fitness Benefit
A-Usually earned by working
B-20% Co-insurance
D-Step Therapy
S-D
A-$682 Co-Pay
(91 until)
D-Quantity Limits
B-Withdraw from Social Security
D-Premium Varies
D-Prior
Authorization
C-Primary Care Physician
D-Copayment
A-Red/Blue/ White
Card
S-A
A-People with Certain Disabilities
D-Co-insurance
A-Inpatient Care
B-IRMAA
D-Deductible Phase
C-One Card
for Everything
S-Accepted by all Providers
A-$176 copay
SNF
(21-100)
S-No Networks
S-C
D-Use with Original Medicare
A-ALL COST
SNF
D-Tier 1
D-Cata-strophic Phase
D-$32.74
Late Enroll
Premium
B-Red/Blue/
White
Card
S-N
C-Must not have ESRD
S-Travel the World
A-$0 Co-Insurance
(1-60)
C-Dental
Coverage
S-L
S-Higher Premiums
B-Limited Outpatient
RX Drugs
D-Tier 2
C-In-Network
C-Drug Plans
C-Networks
D-Tier 4
B-Covers 80% MA
Services
C-PPO
S-G
A-190 days Impatient (psych)
B-$13.00 Beneficiary Deductible
B-Withdraw from RRB