Aetna – Mastery Test – Healthcare & Insurance Training – assessment material

Aetna – Mastery Test – Healthcare & Insurance Training – assessment
material


A CMS group waiver allows Aetna to enroll retirees who live outside of the Aetna Medicare
network service area in a PPO-ESA plan if the majority of the plan sponsor's retirees (more than
51%) live inside the network service area. - correct answer ✔✔True



For PPO and HMO plans, all medical expenses covered by Medicare Parts A & B apply toward
the Maximum Out-of-Pocket (MOOP) limit except hearing aid and eyewear reimbursements,
and Medicare Prescription drug coverage. - correct answer ✔✔True



Medicare Advantage plans can be integrated with prescription drug coverage. - correct answer
✔✔True



PPO and HMO plans do not include medical management and care management. - correct
answer ✔✔False



Which plan allows members to seek non-emergency care, without a referral, from providers
who are in and out of the Aetna Medicare Advantage provider network? - correct answer
✔✔PPO



Which plan requires members to use only network providers? - correct answer ✔✔HMO



Aetna Medicare's PPO plans offer variable amount for the deductible and the Maximum Out-of-
Pocket (MOOP) limits. - correct answer ✔✔True



For Aetna Medicare HMO and PPO plans, some services like preventive care, emergency and
urgently needed care will not apply to the deductible. - correct answer ✔✔True