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Exam (elaborations)

UHC 2021 Chronic Condition and Dual Special Needs Plans Certification (English)

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When does the Special Election Period for Dual/LIS Change in Status begin for DSNP members that lose Medicaid eligibility? - Answer- Wrong - The month after they are notified by the plan of the loss of Medicaid eligibility; Wrong - After the Grace Period ends Which consumer might benefit the most by enrolling in a DSNP? - Answer- A: Joe, who receives Qualified Medicaid Beneficiary benefits (QMB+) Which statement best describes a care management program that varies depending upon the level of the member's health risk? - Answer- Wrong - Support provided only to members who have multiple chronic conditions and receive state Medicaid benefits Which statement best describes a DSNP? - Answer- A: The monthly premium is at or below the Low Income Subsidy benchmark to cover drug costs When selling DSNPs, agents must: - Answer- A: Confirm the consumer's Medicaid level and that the consumer is entitled to Medicare Part A and enrolled in Part B The consumer states they currently pay a percentage of charges when they receive medical care. This means: - Answer- A: Wrong - Medicaid Supplemental Plan Which of the following consumer characteristics demonstrates a good fit for a CSNP? - Answer- A: A consumer with a qualifying chronic condition who wants a plan that will help them manage their illness and health care costs On July 19, each of the following consumers met with an agent. Based on the information provided, which consumer must wait until the Annual Election Period (AEP) or Open Enrollment Period (OEP) to enroll? - Answer- A: Joy has a cardiovascular disorder, is enrolled in a CSNP that covers the condition, and wants to enroll in another CSNP offered by the plan that covers the same condition. Which is a service provided to a CSNP or DSNP member placed in the low to moderate care management risk level? - Answer- A: ALL of the responses Which statement is true about physician information on the Chronic Condition Verification Form? - Answer- A: The physician indicated on the form does not have to be contracted with the plan. Which statement is true about the Medicaid program? - Answer- A:It helps pay medical costs for certain groups of people with limited income and resources.

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Uploaded on
June 24, 2023
Number of pages
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Written in
2022/2023
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