Name: Score:
157 Multiple choice questions
Term 1 of 157
Medicare supplement insurance policies cannot be used in conjunction with what type of plan?
Prescription drug plan
Pffs plan
The monthly plan premium
MA plan
Term 2 of 157
Medicare part D is a state program or a federal program
state program
federal program
private
joint federal/state program
,Definition 3 of 157
1) member has more than one chronic health condition
2) Member takes several different medications
3) Member's medications have a combined cost of more than $3,919 per year
( the dollar amount can change per year) is estimated based on OOP costs and the costs the plan
pays for the medications each calendar year. the plan can help members determine if they may
reach this dollar limit.
to be enrolled in the MTM program ( medication therapy program) the enrolled member
must meet all of the following
Only enroll a dual eligible customer into a PFFS plan if the customer insists on enrolling and
disclose the potential impacts of
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services?
There are 4 stages to medicare part standard prescription drug coverage; what are they?
Term 4 of 157
In order to be eligible for part D, what must a client also have?
Part A and B
Ma Plan
A Stand-alone Part d Plan.
Part E, F, G, H
Term 5 of 157
MSA?
Medical savings account
The monthly plan premium
Medical insurance
Tax shelter contract
,Term 6 of 157
WHat type of stand alone variations to medicare can give extra benefits?
Tier 1, 2,3,4,5
formulary
A+B+D
C+D
medicaid
Term 7 of 157
What type of plans are network based plans?
Enrolling
Hmo, Pos, Ppo, Rppo, Pffs, Snp, and Msa
HMO's, POS's, and PPO's
Pffs
Term 8 of 157
what does MMP stand for?
Medicare-medicaid plan
Part d plan
Non-pffs ma-only plan
Medicare advantage plans
, Term 9 of 157
Plans must ___ what is permitted in the terms and conditions of payment
assume
decide
ignore
review
Term 10 of 157
Money spent ( excluding premiums) during the Deductible, initial coverage and coverage gap
stages count toward ____, which determines when a member moves from the drug coverage stage
to the next
Out-of-pocket Maximum
Annual Limit
TrOOP
Coverage Exclusion
Term 11 of 157
Can a member with a POS plan see a specialist?
Yes
No
Term 12 of 157
in a MA-part D plan, A member will be disenrolled from their MA-PD upon enrollment in?
ma-pd
initial enrollment Period
a stand-alone PDP
the monthly plan premium
157 Multiple choice questions
Term 1 of 157
Medicare supplement insurance policies cannot be used in conjunction with what type of plan?
Prescription drug plan
Pffs plan
The monthly plan premium
MA plan
Term 2 of 157
Medicare part D is a state program or a federal program
state program
federal program
private
joint federal/state program
,Definition 3 of 157
1) member has more than one chronic health condition
2) Member takes several different medications
3) Member's medications have a combined cost of more than $3,919 per year
( the dollar amount can change per year) is estimated based on OOP costs and the costs the plan
pays for the medications each calendar year. the plan can help members determine if they may
reach this dollar limit.
to be enrolled in the MTM program ( medication therapy program) the enrolled member
must meet all of the following
Only enroll a dual eligible customer into a PFFS plan if the customer insists on enrolling and
disclose the potential impacts of
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services?
There are 4 stages to medicare part standard prescription drug coverage; what are they?
Term 4 of 157
In order to be eligible for part D, what must a client also have?
Part A and B
Ma Plan
A Stand-alone Part d Plan.
Part E, F, G, H
Term 5 of 157
MSA?
Medical savings account
The monthly plan premium
Medical insurance
Tax shelter contract
,Term 6 of 157
WHat type of stand alone variations to medicare can give extra benefits?
Tier 1, 2,3,4,5
formulary
A+B+D
C+D
medicaid
Term 7 of 157
What type of plans are network based plans?
Enrolling
Hmo, Pos, Ppo, Rppo, Pffs, Snp, and Msa
HMO's, POS's, and PPO's
Pffs
Term 8 of 157
what does MMP stand for?
Medicare-medicaid plan
Part d plan
Non-pffs ma-only plan
Medicare advantage plans
, Term 9 of 157
Plans must ___ what is permitted in the terms and conditions of payment
assume
decide
ignore
review
Term 10 of 157
Money spent ( excluding premiums) during the Deductible, initial coverage and coverage gap
stages count toward ____, which determines when a member moves from the drug coverage stage
to the next
Out-of-pocket Maximum
Annual Limit
TrOOP
Coverage Exclusion
Term 11 of 157
Can a member with a POS plan see a specialist?
Yes
No
Term 12 of 157
in a MA-part D plan, A member will be disenrolled from their MA-PD upon enrollment in?
ma-pd
initial enrollment Period
a stand-alone PDP
the monthly plan premium
