Aetna 2019 questions well answers updated to pass

Aetna 2019Aetna offers a variety of Aetna and Coventry Medicare Advantage plan types. Which plan type requires a person to use only network providers? (excluding emergency or urgently needed services) - correct answer HMO plan Which plan type allows members to see preferred doctors out of network and does not require referrals to a specialist? - correct answer PPO Plan Most Aetna and Coventry Medicare Advantage plans are integrated with prescription drug coverage, so they are called MAPD plans. - correct answer True Aetna and Coventry case Management consists of registered nurses, social workers, behavioral health professionals and pharmacists who help members navigate the health care system and access services. - correct answer True Aetna Medicare Advatage HMO and PPO plans have no out-of-pocket maximum. - correct answer False Aetna Medicare Advantage HMO and PPO plans cover routine preventive care including an annual wellness visit, screening mammograms, and prostate cancer screenings. - correct answer True A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy. - correct answer True All MAPD plans have a prescription drug component. - correct answer True Which of the following are true? - correct answer All of the above. You can find a quick list of tools on What is a Dual eligible Special Needs Plan (D-SNP)? - correct answer All of the above Low Income Subsidy (LIS) is a Mediare finacial program that helps to reduce prescription drug costs. - correct answer True The difference between LIS and the Medicare Savings Program (MSP) is LIS helps reduce prescription drug costs and MSP helps with Medicare plan premiums, deductibles and copayments/coinsurance with medical services. - correct answer True Individuals can apply for Extra Help through: - correct answer All of the above. A full dual eligible means an individual has Medicare, but is only eligible for assistance with Medicare premiums and sometimes cost share through the Medicare Saving Program. - correct answer False. LIS Medicare drug plan premium and deductible costs are based on income level. - correct answer True Full benefit duals meet state Medicaid eligibility requirements and are entitled to receive the Medicaid services they need. - correct answer True One of Aetna's model of Care goals is to improve use of preventive health services. - correct answer True Which are attributes of the Aetna's Model of Care: - correct answer All of the above The Aetna DSNP care manager and care team provide a single point-of-contact to help coordinate all Medicare and Medicaid covered care and services that the member needs. - correct answer True Members may qualify for transition of coverage if they Part D drug they're taking is no longer on the plan's formulary or the drug is restricted by a utilization management edit. - correct answer True All markets offer three PDPs in all 50 states, plus the D.C., to meet the needs of our members. - correct answer True