2025 - ANTHEM HMO, PPO, DSNP, CSNP
| COMPREHENSIVE QUESTIONS & ANSWERS |
GRADE A | 100% CORRECT -THE ULTIMATE
GUIDE FOR YR. (2026/2027)
Quiz_________________?
The beneficiary must continue to pay the Medicare Part B premium in order to
be eligible for the HMO plan. -
Answer☑️
True
Quiz_________________?
Which of the following statements regarding eligibility criteria for Medicare
Advantage HMO plans is true? -
Answer☑️
All of the above statements are true.
Quiz_________________?
If the member obtains preventive care and screening tests from out-of-network
providers, neither Medicare nor the HMO plan will be responsible for the costs.
The member will be responsible for the costs in this case. -
Answer☑️
1
, True
Quiz_________________?
Some plans may have narrow or select networks. With these plans, if the
enrollee chooses a PCP that is part of an IPA or medical group, the specialists,
ancillary providers, and hospitals available to them may be limited to only those
contracted with the PCP's IPA or medical group. -
Answer☑️
True
Quiz_________________?
Coinsurance is defined as: -
Answer☑️
A percentage
Quiz_________________?
Prescription drug costs under Part D apply toward the medical out-of-pocket
maximum. -
Answer☑️
False
Quiz_________________?
For a beneficiary who enrolled in a MA-only plan during the Annual Election
Period, they will not be able to enroll in a plan that offers prescription drug
coverage until the following Annual Election Period; unless the beneficiary
chooses to use their one-time election during the Open Enrollment Period or
qualifies for a Special Election Period. -
2
| COMPREHENSIVE QUESTIONS & ANSWERS |
GRADE A | 100% CORRECT -THE ULTIMATE
GUIDE FOR YR. (2026/2027)
Quiz_________________?
The beneficiary must continue to pay the Medicare Part B premium in order to
be eligible for the HMO plan. -
Answer☑️
True
Quiz_________________?
Which of the following statements regarding eligibility criteria for Medicare
Advantage HMO plans is true? -
Answer☑️
All of the above statements are true.
Quiz_________________?
If the member obtains preventive care and screening tests from out-of-network
providers, neither Medicare nor the HMO plan will be responsible for the costs.
The member will be responsible for the costs in this case. -
Answer☑️
1
, True
Quiz_________________?
Some plans may have narrow or select networks. With these plans, if the
enrollee chooses a PCP that is part of an IPA or medical group, the specialists,
ancillary providers, and hospitals available to them may be limited to only those
contracted with the PCP's IPA or medical group. -
Answer☑️
True
Quiz_________________?
Coinsurance is defined as: -
Answer☑️
A percentage
Quiz_________________?
Prescription drug costs under Part D apply toward the medical out-of-pocket
maximum. -
Answer☑️
False
Quiz_________________?
For a beneficiary who enrolled in a MA-only plan during the Annual Election
Period, they will not be able to enroll in a plan that offers prescription drug
coverage until the following Annual Election Period; unless the beneficiary
chooses to use their one-time election during the Open Enrollment Period or
qualifies for a Special Election Period. -
2
