Aetna MA/MAPD/DSNP Mastery Test questions and Answers Latest Update Fully Solved 100%

A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy. True or False - True A) A type of MAPD plan designed to provide targeted care and services to individuals with specific needs. B) A MA plan that tailors benefits, provider choices and drug formularies to meet specific needs of the groups they serve. C) A MA plan for those who are eligible for Medicare and Medicaid. D) A MA plan required to contract with a state Medicaid agency. E) All of the above - E) All of the above Which plan type allows members to see preferred doctors in network, doctors out of network and does not require referrals to a specialist? A) PDP plan B) Cost plan C) PPO plan D) HMO plan - C) PPO Which are attributes of the Aetna's Model of Care: A) An Interdisciplinary Care Team approach B) Clinical Programs to improve health and well-being C) Transition of Care Program D) A and B E) All of the above - E) All of the aboveMost Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they are called MAPD plans. True or False - True 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. True or False - True Aetna case management consists of registered nurses, social workers, behavioral health professionals and pharmacists who help members navigate the health care system and access services. True or False - True Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum. True or False - False Aetna Medicare Advantage HMO and PPO plans cover routine preventative care including an annual wellness visit, screening mammograms, and prostate cancer screenings. True or False - True All MAPD plans have a prescription drug component. True or False - True Which of the following are true?A) The PPO plans provide access to services from doctors in the PPO network at a lower out-of-pocket cost. B) In the Open Access HMO plan, members can go to any Aetna Medicare Plan HMO network doctor they choose for covered services without a PCP referral as long as the doctor is a contracted HMO doctor. C) All of the Medicare Advantage plans include free monthly fitness club memberships to any facility participating within the SilverSneakers network. D) All of the above - D) All of the above Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a person to use only network providers? A) PDP plan B) HMO plan C) PPO plan D) ESRD plan - B) HMO