Model: vivnatan/snowflake-arctic-embed-l-medicare
Author: vivnatan
Pipeline: sentence-similarity
Library: sentence-transformers
Tags: sentence-transformers, safetensors, bert, sentence-similarity, feature-extraction, generated_from_trainer, dataset_size:910, loss:MatryoshkaLoss, loss:MultipleNegativesRankingLoss, arxiv:1908.10084, arxiv:2205.13147, arxiv:1705.00652, base_model:Snowflake/snowflake-arctic-embed-l, base_model:finetune:Snowflake/snowflake-arctic-embed-l, model-index, text-embeddings-inference, endpoints_compatible, region:us
Base models (finetune): id: Snowflake/snowflake-arctic-embed-l
Card metadata: tags: sentence-transformers, sentence-similarity, feature-extraction, generated_from_trainer, dataset_size:910, loss:MatryoshkaLoss, loss:MultipleNegativesRankingLoss
base_model: Snowflake/snowflake-arctic-embed-l
widget: source_sentence: How long after your Initial Enrollment Period ends do you have to avoid a tax penalty by making your last HSA contribution?
sentences: 86
Section 6: Medicare drug coverage (Part D)
86
Plans can change their formularies at any time. Your plan may notify you of 
any formulary changes that affect drugs you’re taking. 
Contact your plan for its current formulary, or visit the plan’s website. 
You can also visit Medicare.gov/plan-compare or call 1-800-MEDICARE 
(1-800-633-4227) to find out if a drug is on your plan’s formulary. TTY users 
can call 1-877-486-2048. 
Important! Each month you fill a prescription, your plan sends you 
an “Explanation of Benefits” notice. Review your notice and check it 
for mistakes. Contact your plan if you have questions or find mistakes. 
If you suspect fraud, call the Medicare Drug Integrity Contractor at 
1-877-7SAFERX (1-877-772-3379). Go to page 106. 
Plans may have coverage rules for certain drugs 
• Prior authorization: Limits coverage of a drug to patients who meet certain 
requirements. Before you can fill the prescription, your prescriber must 
contact your plan to show the drug is medically necessary and that you 
meet certain requirements. 
Plans may also use prior authorization when they cover a drug for only 
certain medical conditions it’s approved for, but not others. When this 
occurs, plans will likely have alternative drugs on their list of covered drugs 
(formulary) for the other medical conditions the drug is approved to treat. 
Contact your plan or visit their website to find out about prior authorization 
requirements.
• Quantity limits: Limits how much of a drug you can get at a time. 
• Step therapy: You may need to try one or more similar, lower-cost drugs 
before the plan will cover the prescribed drug. 
• Opioid pain medication safety checks at the pharmacy: Before the 
pharmacy fills your prescriptions, your plan and pharmacy perform 
additional safety checks, like checking for drug interactions and incorrect 
dosages. 
 
The opioid safety checks also include checking for possible unsafe 
amounts of opioid pain medications, limiting the day’s supply of a first, Enrollment Period
You can avoid a tax penalty 
by making your last HSA 
contribution the month before 
you turn 65.
2 months after your Initial 
Enrollment Period ends
And your birthday is on 
the 1st day of the month
Generally, your Medicare 
coverage starts the first day 
of the month before you turn 
65. You can avoid a tax penalty 
by making your last HSA 
contribution 2 months before 
you turn 65.
If you wait to 
sign up for 
Medicare:
Less than 6 months after 
you turn 65
You can avoid a tax penalty by 
stopping HSA contributions the 
month before you turn 65.
6 or more months after 
you turn 65
You can avoid a tax penalty by 
stopping HSA contributions 6 
months before the month you 
apply for Medicare.
Note: A Medical Savings Account (MSA) Plan is similar to an HSA. Go to page 67., to a third-party app. Go to page 109.
What’s assignment? 
Assignment means that your doctor, provider, or supplier agrees (or is 
required by law) to accept the Medicare-approved amount as full payment for 
covered services. Most doctors, providers, and suppliers accept assignment, 
but always check to make sure that yours do.
If your doctor, provider, or supplier accepts assignment: 
• Your out-of-pocket costs may be less. 
• They agree to charge you only the Medicare deductible and coinsurance 
amount and usually wait for Medicare to pay its share before asking you to 
pay your share. 
• They have to submit your claim directly to Medicare and can’t charge you 
for submitting the claim., source_sentence: Under what circumstances can you change your Medicare Advantage plan during the year?
sentences: 19
Section 1: Signing up for Medicare
19
I have other health coverage. Should I get Part B?
This information can help you decide if you should get Part B based on the 
type of health coverage you may have. 
Employer or union coverage
If you or your spouse (or family member if you have a disability) are still 
working and you have health coverage through that employer or union, go 
to page 21 to find out how your coverage works with Medicare. You can also 
contact the employer or union benefits administrator for information. This 
includes federal or state employment and active-duty military service. It might 
be to your advantage to delay Part B enrollment while you still have health 
coverage based on your or your spouse’s current employment. 
Coverage based on current employment doesn’t include: 
• COBRA (or similar continuation coverage after employment ends) 
• Retiree coverage 
• VA coverage 
• Individual health insurance coverage (like through the Health Insurance 
Marketplace®) 
• Former employer coverage you get through severance or a layoff
TRICARE
If you have TRICARE (health care program for active-duty and retired service 
members and their families), you generally must sign up for Part A and 
Part B when you’re first eligible to keep your TRICARE coverage. However, 
if you’re an active-duty service member or an active-duty family member, you 
don’t have to sign up for Part B to keep your TRICARE coverage. For more 
information, contact your TRICARE contractor. Go to page 90. 
If you have CHAMPVA coverage, you must sign up for Part A and Part B to 
keep it. Call 1-800-733-8387 for more information about CHAMPVA.
Medicaid
If you have Medicaid and don’t have Part B, Medicare will pay first for the 
Part A services Medicare covers. You may also be able to get help from your 
state to pay for Part A and Part B premiums through a Medicare Savings 
Program. Go to pages 91–92. To learn more about signing up for Part B, go to 
page 15.
For more information on Medicaid and to find out if you qualify, visit, •	 You’ll generally get a decision from the Medicare Administrative Contractor 
within 60 days after they get your request. If Medicare will cover the item(s) 
or service(s), it will be listed on your next MSN.
•	 You may have the right to a fast appeal if you think your Medicare services 
from a hospital or other facility are ending too soon (page 100).
If you’re in a Medicare Advantage or other Medicare health plan 
The timeframe for filing an appeal may be different than Original Medicare. 
In some cases, you can file a fast appeal. To learn more, look at the materials 
your plan sends you, call your plan, or visit Medicare.gov/claims-appeals/how-
do-i-file-an-appeal. 
If you have a separate Medicare drug plan 
Even before you buy a certain drug, you have the right to:
•	 Get a written explanation for drug coverage decisions (called a “coverage 
determination”) from your Medicare drug plan. A coverage determination is 
the first decision your Medicare drug plan (not the pharmacy) makes about 
your benefits. This can be a decision about if the plan covers your drug, if 
you met the plan’s requirements to cover the drug, or how much you pay for 
the drug. You’ll also get a coverage determination decision if you ask your 
plan to make an exception to its rules to cover your drug. 
•	 Ask for an exception if you or your prescriber (your doctor or other health 
care provider who’s legally allowed to write prescriptions) believe you need 
a drug that isn’t on your plan’s list of covered drugs (formulary)., 63
Section 4: Medicare Advantage Plans & other options
63
Providers can join or leave a plan’s provider network any time during the year. 
Your plan can also change the providers in the network any time during the 
year. If this happens, you usually won’t be able to change plans but you can 
choose a new provider. You generally can’t change plans during the year.
Important! Even though the network of providers may change during 
the year, the plan must still give you access to qualified doctors and 
specialists. Your plan will notify you that your provider is leaving your 
plan so you have time to choose a new one. You’ll get this notice if it’s 
a primary care or behavioral health provider and you’ve gone to that 
provider in the past three years. If any of your other providers leave your 
plan, you’ll get this notice in certain situations. 
Your plan will also: 
• Help you choose a new provider to continue managing your health care 
needs.
• Help you continue needed care that’s already in progress.
• Notify you about the different enrollment periods available to you and 
options you may have for changing plans.
Read your notices carefully so you’re aware of any changes and can change 
plans if you aren’t satisfied, either during Open Enrollment or a Special 
Enrollment Period, if you qualify.
When an in-network provider or benefit isn’t available or can’t meet your 
medical needs, your plan must help you get any medically necessary covered 
services outside the provider network (at the in-network cost sharing). 
Compare: If you have Original Medicare, you don’t need a referral to 
use a specialist in most cases (page 57), and you generally don’t need 
prior approval to use a covered benefit. 
Important! Read the information you get from your plan 
If you’re in a Medicare Advantage Plan, review the “Annual Notice of 
Change” and “Evidence of Coverage” from your plan each year.
• 
Annual Notice of Change: Includes any changes in coverage, costs, 
and more that will be effective in January. Your plan will send you a 
printed copy by September 30.
• 
Evidence of Coverage: Gives you details about what the plan covers,, source_sentence: What topics are covered on pages 29 to 45?
sentences: Acupuncture 30, 87
Advance Beneficiary Notice of  
Non-coverage (ABN) 101–102
Advance care planning 30–31, 35, 54
Alcohol misuse screenings & counseling 31
Ambulance services 31, 53
Ambulatory surgical centers 31
Amyotrophic lateral sclerosis (ALS) 15
Appeal 28–29, 58, 62, 66, 87, 97–101, 108, 
112
Artificial limbs 49
Assignment 29–45, 47–48, 54–55, 58, 
59–60, 65, 119
B
Balance exam 42
Behavioral health integration services 32, 
87
Beneficiary and Family Centered  
Care-Quality Improvement 
Organizations 100, 112
Benefit period 27, 29, 119
Benefits coordination 21–22, 89–90, 112
Bills 23–24, 58–59, 82, 89, 91, 99, 102, 105, 
108–109
Blood 26, 32–33, 35–36, 38–39, 42–44, 76
Blood-based biomarker test 36
Braces (arm, leg, back, neck) 49
Index of topics, Note: You can 
only switch 
plans once 
during this 
period.
Medicare uses ratings from 1–5 stars to 
help you compare plans based on quality 
and performance. 
If a Medicare Advantage Plan, Medicare 
drug plan, or Medicare Cost Plan with a 
5-star quality rating is available in your 
area, you can use the 5-star Special 
Enrollment Period to switch from your 
current Medicare plan to a Medicare plan 
with a 5-star quality rating.
Visit Medicare.gov for more information., copayment or coinsurance. 
Do these plans cover prescription drugs? 
In most cases, yes. If you’re planning to enroll in an HMO and you want 
Medicare drug coverage (Part D), you must join an HMO Plan that offers 
Medicare drug coverage. If you join an HMO Plan without drug coverage, you 
can’t join a separate Medicare drug plan.
Do I need to choose a primary care doctor? 
In most cases, yes. 
Do I have to get a referral to use a specialist? 
In most cases, yes. Certain services, like yearly mammogram screenings, don’t 
require a referral., source_sentence: Where can information about Substance Use Disorder treatments be found?
sentences: Service area 11, 64, 74, 79, 81, 122
Sexually transmitted infection screenings 
and counseling 50
SHIP. Go to State Health Insurance 
Assistance Program.
Shots (vaccines) 9, 37, 41, 42, 48, 50, 54, 
108, 122
Sigmoidoscopy 35–36
Skilled nursing facility (SNF) care 9, 25, 28, 
74, 76, 100, 101, 110, 122
SNF. Go to Skilled nursing facility (SNF) 
care.
SNP. Go to Special Needs Plan.
Social Security
Change address on MSN 59
Extra Help paying Part D costs 92
Other helpful contacts 112–113
Part A and Part B premiums 22–24
Part D premium 82
Sign up for Part A and Part B 15–19
Supplemental Security Income (SSI) 
benefits 93, 96
SPAP. Go to State Pharmacy Assistance 
Program.
Special Enrollment Period
Part A and Part B 17–18, 23
Part C (Medicare Advantage plans) 71–73
Part D (Medicare drug plans) 80, 89, 93
Special Needs Plan (SNP) 61, 70
Speech-language pathology 39, 43, 51
SSI. Go to Supplemental Security Income.
State Health Insurance Assistance Program 
(SHIP) 14, 16, 56, 60, 73, 77, 78, 80, 83, 
89, 94, 95, 100, 105, 108, 114–117
State Medical Assistance (Medicaid) 70
State Medical Assistance (Medicaid) 
office 56, 58, 91, 95–96, 124
State Pharmaceutical Assistance 
Programs 95
Substance use disorder treatments 47, 51, 
54, 55, 86–87, coverage begins, and you’ll have a Special Enrollment Period to change 
plans if you want to join a different plan than the one Medicare enrolled 
you in. 
•	 Different plans cover different drugs. Check to find out if the plan you’re 
enrolled in covers the drugs you use and if you can go to the pharmacies 
you want. Visit Medicare.gov/plan-compare or call 1-800-MEDICARE 
(1‑800‑633-4227) to compare your plan with other plans in your area. 
TTY users can call 1-877-486-2048. 
•	 If you have Medicaid and live in certain institutions (like a nursing home) or 
get certain home and community-based services, you pay nothing for your 
covered drugs. 
•	 Drug costs for people who qualify will generally be no more than $4.50 for 
each generic drug and $11.20 for each brand-name drug you fill at one of 
your plan’s participating pharmacies. Look at the Extra Help letters you get, 
or contact your plan if you have questions about costs., employment, your employer or union will notify you each year to let you know 
if your drug coverage is creditable. Keep the information you get. Call your 
benefits administrator for more information before making any changes to 
your coverage. 
Important! If you get Medicare drug coverage, you, your spouse, or your 
dependents may lose your employer or union health coverage., source_sentence: What are the consequences of not signing up for Medicare Part B when you are first eligible?
sentences: Will I have to sign up for Part A and/or Part B?
If you’re close to 65, but NOT getting Social Security or RRB benefits, you’ll 
need to sign up for Medicare. Visit SSA.gov/medicare to apply for Part A and 
Part B. You can also contact Social Security 3 months before you turn 65 to 
set up an appointment. If you worked for a railroad, visit RRB.gov, or call the 
RRB at 1-877-772-5772. TTY users can call 1-312-751-4701. 
In most cases, if you don’t sign up for Part B when you’re first eligible, you may 
have a delay in getting Medicare Part B coverage in the future because you 
can only sign up at certain times. You may also have to pay a late enrollment 
penalty for as long as you have Part B. Go to page 23., •	 Visit ACL.gov/ltc to learn more about planning for long‑term care. 
•	 Visit the Eldercare Locator at eldercare.acl.gov, or call 1-800-677-1116 to 
find help in your community.
•	 Call your Long-Term Care Ombudsman, or visit ltcombudsman.org for help 
with services you need and to be advised of your rights, and to find an 
Ombudsman program near you.
•	 Call your State Medical Assistance (Medicaid) office or visit Medicaid.gov 
and ask for information about long-term care coverage. 
•	 Call your State Health Insurance Assistance Program (SHIP). Go to 
pages 114–117 for the phone number of your local SHIP. 
•	 Call your State Insurance Department for information on long‑term care 
insurance. Call 1-800-MEDICARE (1‑800‑633‑4227) to get the phone 
number. TTY users can call 1‑877‑486‑2048.
•	 Get a copy of “A Shopper’s Guide to Long-Term Care Insurance” from the 
National Association of Insurance Commissioners at content.naic.org/sites/
default/files/publication-ltc-lp-shoppers-guide-long-term.pdf., 47
Section 2: Find out what Medicare covers
47
Preventive service  
Obesity behavioral therapy 
If you have a body mass index (BMI) of 30 or more, Medicare covers obesity 
screenings and behavioral counseling to help you lose weight by focusing on 
diet and exercise. Medicare covers this counseling if your primary care doctor 
or other primary care provider gives the counseling in a primary care setting 
(like a doctor’s office), where they can coordinate your personalized plan with 
your other care. You pay nothing for this service if your primary care doctor or 
other provider accepts assignment. 
Occupational therapy services
Medicare covers medically necessary therapy to help you perform activities of 
daily living (like dressing or bathing). This therapy helps to improve or maintain 
current capabilities or slow decline when your doctor or other health care 
provider certifies you need it. You pay 20% of the Medicare-approved amount. 
The Part B deductible applies. 
Opioid Use Disorder treatment services 
Medicare covers Opioid Use Disorder treatment services in Opioid Treatment 
Programs. The services include medication (like methadone, buprenorphine, 
naltrexone, naloxone, and nalmefene hydrochloride), dispensing and 
administering medications, substance use counseling, drug testing, individual 
and group therapy, intake activities, periodic assessments, and intensive 
outpatient services. Medicare covers counseling, therapy services, and periodic 
assessments both in-person and, in certain circumstances, virtually (using 
audio and video communication technology like your phone or a computer). 
Medicare also covers services given through Opioid Treatment Program mobile 
units.
Medicare pays doctors and other providers for office-based Opioid Use 
Disorder treatment, including management, care coordination, psychotherapy, 
counseling activities, and allotment and distribution of medications. 
Under Original Medicare, you won’t have to pay any copayments for these 
services if you get them from an Opioid Treatment Program provider that’s 
enrolled in Medicare and meets other requirements. However, the Part B 
deductible still applies. Talk to your doctor or other health care provider to
pipeline_tag: sentence-similarity
library_name: sentence-transformers
metrics: cosine_accuracy@1, cosine_accuracy@3, cosine_accuracy@5, cosine_accuracy@10, cosine_precision@1, cosine_precision@3, cosine_precision@5, cosine_precision@10, cosine_recall@1, cosine_recall@3, cosine_recall@5, cosine_recall@10, cosine_ndcg@10, cosine_mrr@10, cosine_map@100
model-index: name: SentenceTransformer based on Snowflake/snowflake-arctic-embed-l
results: task: type: information-retrieval
name: Information Retrieval
dataset: name: Unknown
type: unknown
metrics: type: cosine_accuracy@1
value: 0.7
name: Cosine Accuracy@1
verified: no, type: cosine_accuracy@3
value: 0.915
name: Cosine Accuracy@3
verified: no, type: cosine_accuracy@5
value: 0.97
name: Cosine Accuracy@5
verified: no, type: cosine_accuracy@10
value: 1
name: Cosine Accuracy@10
verified: no, type: cosine_precision@1
value: 0.7
name: Cosine Precision@1
verified: no, type: cosine_precision@3
value: 0.305
name: Cosine Precision@3
verified: no, type: cosine_precision@5
value: 0.19399999999999998
name: Cosine Precision@5
verified: no, type: cosine_precision@10
value: 0.1
name: Cosine Precision@10
verified: no, type: cosine_recall@1
value: 0.7
name: Cosine Recall@1
verified: no, type: cosine_recall@3
value: 0.915
name: Cosine Recall@3
verified: no, type: cosine_recall@5
value: 0.97
name: Cosine Recall@5
verified: no, type: cosine_recall@10
value: 1
name: Cosine Recall@10
verified: no, type: cosine_ndcg@10
value: 0.8620935123539408
name: Cosine Ndcg@10
verified: no, type: cosine_mrr@10
value: 0.8164365079365079
name: Cosine Mrr@10
verified: no, type: cosine_map@100
value: 0.8164365079365079
name: Cosine Map@100
verified: no
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Created: 2025-05-13 15:26:30