VERIFIED ANSWERS |LATEST 2026/2027 UPDATE|GRADED
A+
Question 1
Which type of MA Plan is an HMO plan that also covers certain benefits out-of-network,
generally at a higher cost? Medicare Supplement Insurance Plan Private Fee-for-Service
(PFFS) Point-of-Service (POS) Plan Preferred Provider Organization (PPO)
CORRECT ANSWER
Preferred Provider Organization (PPO)
Question 2
Which statement is true about the MA out-of-pocket maximum? A Medicare Advantage
Prescription Drug Plan (MAPD) member's costs for prescription drugs and any benefits not
covered by Original Medicare count toward the out-of-pocket maximum. All MA plans
have an out-of-pocket maximum to help limit the member's out-of-pocket costs for
Medicare-covered medical services. The out-of-pocket maximum amount is determined by
Medicare each year and is the same for all MA plans.
CORRECT ANSWER
All MA plans have an out-of-pocket maximum to help limit the member's out-of-pocket
costs for Medicare-covered medical services.
Question 3
Which consumer is eligible for a standalone Medicare Prescription Drug Plan (PDP)?
Sharon, who is not enrolled in Medicare Part A or Medicare Part B, and lives in the plan's
service area. Joseph, who is enrolled in Medicare Part A and Medicare Part B and lives in
the plan's service area. Alice, who is enrolled only in Medicare Part A, but does not live in
the plan's service area. Alvin, who is enrolled only in Medicare Part B, but does not live in
the plan's service area.
1
@THE STUDY VAULT
, CORRECT ANSWER
Joseph, who is enrolled in Medicare Part A and Medicare Part B and lives in the plan's
service area.
Question 4
In what order do the 3 prescription drug coverage stages occur? Initial Coverage,
Deductible, Catastrophic Coverage Catastrophic Coverage, Initial Coverage, Deductible
Deductible, Initial Coverage, Catastrophic Coverage Deductible, Catastrophic Coverage,
Initial Coverage
CORRECT ANSWER
Deductible, Initial Coverage, Catastrophic Coverage
Question 5
Which of the following is true about Medicare Supplement Plans?
They are regulated by the Centers for Medicare & Medicaid Services (CMS). Plan benefit
amounts automatically update when Medicare changes cost sharing amounts, such as
deductibles, coinsurance and copayments. They can only be purchased during the Annual
Election Period (AEP). To see a specialist, insured members must get referrals from a
primary care provider.
CORRECT ANSWER
Plan benefit amounts automatically update when Medicare changes cost sharing amounts,
such as deductibles, coinsurance and copayments.
Question 6
Which statements regarding Star Ratings are true? (Select 2) Star Ratings are based on a
plan's performance in several key areas, such as detecting and preventing illness, ratings
from patients, patient safety and customer service. Medicare uses a 5-star rating system to
illustrate the plan's relative popularity in a market as measured by membership and
2
@THE STUDY VAULT
A+
Question 1
Which type of MA Plan is an HMO plan that also covers certain benefits out-of-network,
generally at a higher cost? Medicare Supplement Insurance Plan Private Fee-for-Service
(PFFS) Point-of-Service (POS) Plan Preferred Provider Organization (PPO)
CORRECT ANSWER
Preferred Provider Organization (PPO)
Question 2
Which statement is true about the MA out-of-pocket maximum? A Medicare Advantage
Prescription Drug Plan (MAPD) member's costs for prescription drugs and any benefits not
covered by Original Medicare count toward the out-of-pocket maximum. All MA plans
have an out-of-pocket maximum to help limit the member's out-of-pocket costs for
Medicare-covered medical services. The out-of-pocket maximum amount is determined by
Medicare each year and is the same for all MA plans.
CORRECT ANSWER
All MA plans have an out-of-pocket maximum to help limit the member's out-of-pocket
costs for Medicare-covered medical services.
Question 3
Which consumer is eligible for a standalone Medicare Prescription Drug Plan (PDP)?
Sharon, who is not enrolled in Medicare Part A or Medicare Part B, and lives in the plan's
service area. Joseph, who is enrolled in Medicare Part A and Medicare Part B and lives in
the plan's service area. Alice, who is enrolled only in Medicare Part A, but does not live in
the plan's service area. Alvin, who is enrolled only in Medicare Part B, but does not live in
the plan's service area.
1
@THE STUDY VAULT
, CORRECT ANSWER
Joseph, who is enrolled in Medicare Part A and Medicare Part B and lives in the plan's
service area.
Question 4
In what order do the 3 prescription drug coverage stages occur? Initial Coverage,
Deductible, Catastrophic Coverage Catastrophic Coverage, Initial Coverage, Deductible
Deductible, Initial Coverage, Catastrophic Coverage Deductible, Catastrophic Coverage,
Initial Coverage
CORRECT ANSWER
Deductible, Initial Coverage, Catastrophic Coverage
Question 5
Which of the following is true about Medicare Supplement Plans?
They are regulated by the Centers for Medicare & Medicaid Services (CMS). Plan benefit
amounts automatically update when Medicare changes cost sharing amounts, such as
deductibles, coinsurance and copayments. They can only be purchased during the Annual
Election Period (AEP). To see a specialist, insured members must get referrals from a
primary care provider.
CORRECT ANSWER
Plan benefit amounts automatically update when Medicare changes cost sharing amounts,
such as deductibles, coinsurance and copayments.
Question 6
Which statements regarding Star Ratings are true? (Select 2) Star Ratings are based on a
plan's performance in several key areas, such as detecting and preventing illness, ratings
from patients, patient safety and customer service. Medicare uses a 5-star rating system to
illustrate the plan's relative popularity in a market as measured by membership and
2
@THE STUDY VAULT
