2022 Aetna Individual Medicare Advantage| 100% correct

HMO Traditional Correct Answer: Network providers , PCP SELECTION, REFERRALS REQUIRED some services are considered direct access and don't need a referral; FLU AND PNEUMONIA SHOTS emergency and urgent care mammograms or not in their service area.PCP COPAY WILL APPLY OR SPECIALIST CO PAY WILL APPLY OPEN ACCESS HMO; Network providers, no PCP selection, no referrals Visit Aetna's Once confirmed ready to sell visit indivi medicare section on Aetna's producer world Beginning Oct. 1 indi premiums, etc. will be available Correct Answer: Medicare Advantage Plan types Correct Answer: WE OFFER HIGH QUALITY MEDICARE ADVANTAGE PLANS (MA) HMO AND PPO AVAIL IN 46 STATES 1,874 COUNTIES MOST ARE INTEGRATED WITH PRESCRIPTION DRUG COVERAGE MAPD PLANS Medicare ADVANTAGE PRESCRIPTION PLANS ELIGIBILITY REQUIRMENTS for Medicare Advantage Plans Correct Answer: Have Medicare Parts A and B and lives in the service area Under 65 and received disability benefits for 24 months from SS Received disability benefits from Railroad Retirement Board for 24 months Enrollment periods Correct Answer: include initial coverage election period (ICET) Initial Enrollment Period (IEP) Annual Enrollment Period (AEP) Open Enrollment period (OEP) Special Enrollment period (SEP) Effective date 1st of Month Definitions available on Producer World PPO Correct Answer: OUT OF NETWORK DR HAS TO BE ELIGLE FOR MEDICARE PAYMENTS AND MUST ACCEPT THE PLAN MEMBERS CAN GO TO ANY NETWORK PROVIDER IF THEY GO OUT OF NETWORK THEY MAY HAVE TO PAY A HIGHER COST has a network of providers In a ppo plan members don't have to select a PCP most include prescription drug coverage and a max out of pocket limits (OOP) Correct Answer: coverage for urgent /er medical care anywhere in the world In network coverage Correct Answer: plan covers preventative care, annual wellness visits Glaucoma screenings Bone Mass Measurements Prostate Cancer Screenings