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