QUESTIONS AND ANSWERS VERIFIED 100%
CORRECT
Which of the following lists drug tiers from least expensive cost share to most
expensive cost share?
- -Specialty, Non-Preferred Drug (and some higher-cost generics), Preferred Brand
(and some higher-cost generics), Generics, Preferred Generics
-Preferred Generics, Generics, Preferred Brand (and some higher-cost generics),
Non-Preferred Drug (and some higher-cost generics), Specialty(right) -Generics,
Preferred Generics, Non-Preferred Drug (and some higher-cost generics), Brand
(and some higher cost generics), Specialty
-Preferred Generics, Preferred Brand (and some higher-cost generics), Generics,
Non-Preferred Drug (and some higher-cost generics), Specialty
Which of the following is true about Medicare Supplement Insurance underwriting
criteria in states where underwriting applies?
- -Underwriting is required if the consumer is not in his/her Medicare Supplement
Open Enrollment period or does not meet Guaranteed Issue criteria.(right) -
During Medicare Supplement Open Enrollment, consumers will only be required
to ANSWER the underwriting eligibility questions.
-Consumers will never be underwritten to determine their rate.
-If the consumer meets Guaranteed Issue criteria, he/she may be underwritten to
determine his/her rate.
The new MACRA legislation, which went into effect January 1, 2020, applies to
all carriers offering Medicare supplement plans. - - TRUE(right)
FALSE
Which of the following is true about Medicare Supplement Insurance Plans? – -
-They are regulated by the Centers for Medicare & Medicaid Services (CMS).
-They can only be purchased during the Annual Election Period (AEP). -To
see a specialist, insured members must obtain referrals from a primary care
physician.
-Plan benefit amounts automatically update when Medicare changes cost sharing
amounts, such as deductibles, coinsurance and copayments.(right)
,a consumer currently has original Medicare and is enrolled in a stand alone
prescription drug plan what will happen if the consumer enrolls in an MA plan that
has integrated prescription drug coverage - ANSWER- the consumer will be
automatically disenrolled from the standalone PDP upon in Roman in the MA plan
that has integrated prescription drug coverage
aside from a standalone Medicare prescription drug plan how else could
a
Medicare eligible consumer get Part D prescription drug coverage - ANSWER-
they can enroll in a Medicare Advantage plan or other Medicare health plan that
includes prescription drug coverage
which of the following statements is not true about the coverage gap - ANSWER-
all members reach the coverage gap
which of these statements is true about the drug utilization management UN rules -
ANSWER- prior authorization quantity limit and step therapy are some examples
of the coverage rules
how does a consumer who qualifies for low income subsidy receive financial
assistance through their part of Medicare Part D costs - ANSWER- through
subsidies such as lower or no monthly plan premiums an lower or no copayments
which of the following list drug tiers from least expensive cost share to most
expensive cost share - ANSWER- preferred generics generics preferred brand
nonpreferred drug specialty
which of the following is true about Medicare supplement insurance plans -
ANSWER- plan benefit amounts automatically update when Medicare changes
cost sharing amounts such as deductibles coinsurance and copayments
which definition best describes Medicare Part A - ANSWER- the part of Medicare
that helps with the cost of inpatient hospital stays it also helps with Hospice care
and some skilled care for homebound
, which statement is true about members of a Medicare Advantage plan who wants
to enroll in a Medicare supplement insurance plan - ANSWER- the consumer must
be in a valid MA election or disenrollment.
Who is eligible for Medicare - ANSWER- consumers age 65 or older consumers
under 65 years of age with certain disabilities and consumers of all ages with
ESRD or a LS
which of the following defines a Medicare Advantage plan select two - ANSWER-
MA plans provide Medicare hospital and medical insurance and often include
Medicare prescription drug coverage
MA plans must provide benefits equivalent to original Medicare and most plans
also offer additional benefits
to be eligible for this plan type consumers must meet the following requirements
entitled to Medicare Part A and enrolled in Part B reside in the planned service
area which plan is described - ANSWER- Medicare Advantage
Which type of MA plan is an HMO plan that also covers some benefits out of
network generally at a higher cost - ANSWER- point of service POS plan
when is Marys Medicare supplement open enrollment period if she turns 65 on
September 23rd 2019 and her Medicare Part B effective date is September 1st 2019
- ANSWER- September 2019 through February 2020
a consumer with original Medicare might be interested in an MA plan because -
ANSWER- MA plans typically provide additional coverage beyond original
Medicare and often have established copayments for some benefits
which of the following statements is true about a Medicare supplement insurance
plan member who wants to enroll in an MA plan - ANSWER- Medicare
supplement insurance cannot be used in conjunction with an MA plan therefore
after receiving confirmation of enrollment into the MA plan the member should
submit to their Medicare supplement insurance carrier a written request to cancel
his/her policy