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Medicare Learning

Question 1 of 31

1

Which of the following Medigap Plans provide foreign travel emergency health care coverage when you travel outside the U.S.

Select one or more of the following:

  • A, B, C, F, and N

  • B, C, D, F, G, and N

  • F, K, L, and N

  • C, D, F, G, M, and N

  • B, C, D, F, and N

  • C, D, E, F, G, H, I, J, M, and N

Explanation

Question 2 of 31

1

Foreign travel emergency coverage with Medigap policies has a lifetime limit of

Select one of the following:

  • $45,000

  • $70,000

  • $40,000

  • $50,000

  • $60,000

Explanation

Question 3 of 31

1

Doctors and hospitals bill Medigap carriers directly.

Select one of the following:

  • True
  • False

Explanation

Question 4 of 31

1

Which Medigap plans pay 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year

Select one of the following:

  • Plans C, A, D, E, F, G, H, I, J, M, and N

  • Plans C, D, E, F, G, H, I, J, and N

  • Plans C, D, E, F, G, H, I, J, M, and N

  • Plans C, D, E, H, I, J, M, and N

  • Plans C, D, E, F, G, J, M, and N

Explanation

Question 5 of 31

1

PD plans included with Medicare Advantage Plans are similar to Medicare Part D plans.

Select one of the following:

  • True
  • False

Explanation

Question 6 of 31

1

The ___________ begins when the beneficiary is advised they will be losing group coverage.

Select one of the following:

  • GEP

  • ICEP

  • AEP

  • SEP

  • GDP

Explanation

Question 7 of 31

1

HMO stands for?

Select one of the following:

  • Hospital Maintenance Organizations

  • Health Maintenance Organizations

  • Health Medicare Organizations

Explanation

Question 8 of 31

1

Medicare Part C is a

Select one of the following:

  • Medigap Plan

  • Prescription Drug Plan

  • Medicare Advantage Plan

  • A Standard Medicare Plan

Explanation

Question 9 of 31

1

It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan or a MA

Select one of the following:

  • True
  • False

Explanation

Question 10 of 31

1

PPO Stands for

Select one of the following:

  • Preferred Policy Organization

  • Preferred Provider Organization

  • Private Provider Organization

  • Private Policy Organization

Explanation

Question 11 of 31

1

Medigap premiums may increase with a _____________ day advance notice

Select one of the following:

  • 20

  • 25

  • 35

  • 30

  • 26

  • 40

Explanation

Question 12 of 31

1

Other benefits may also be provided with some Medicare Advantage plans such as:

Select one or more of the following:

  • Dental

  • Accident

  • Hearing

  • Health

  • Vision

  • Fitness

  • Silver Sneakers

Explanation

Question 13 of 31

1

Private Fee for Service

Select one of the following:

  • Requires the beneficiary to select an in network primary care physician.

  • Requires the beneficiary to select a primary care physician from the POS Network.

  • Have a network of doctors who have agreed to accept the plan.

Explanation

Question 14 of 31

1

Medicare Cost plans provide additional coverage to _________to Original Medicare coverage, while Medicare Advantage plans provide __________ coverage that takes place of original medicare coverage.

Select one of the following:

  • add-on / replacement

  • replacement / add-on

  • replacement / stable

  • Universal / replacement

Explanation

Question 15 of 31

1

PPO Network Types Include

Select one or more of the following:

  • National PPO

  • Regional PPO

  • Area PPO

  • District PPO

  • Local PPO

  • Circuit PPO

Explanation

Question 16 of 31

1

A Cost plan is

Select one of the following:

  • A Medigap Plan

  • A Medicare Advantage plan

  • Neither a Medicare Advantage plan or a Medigap Plan

  • A Special Needs Plan

Explanation

Question 17 of 31

1

What is the maximum deductible for Medicare Part D (2016)

Select one of the following:

  • 260

  • 360

  • 460

  • 480

  • 380

  • 560

Explanation

Question 18 of 31

1

To get out of the Coverage Gap the beneficiary must pay ____________ in true out of pocket expenses.

Select one of the following:

  • $4050

  • $4850

  • $4950

  • $4750

Explanation

Question 19 of 31

1

Formulary drugs must be

Select one or more of the following:

  • Avaiable by prescription

  • Approved by the FDA

  • Used and sold in the U.S.

  • Used for a medically-accepted purpose

  • Approved by DOI

  • Approved by CMS

Explanation

Question 20 of 31

1

In most situations, a beneficiary must remain in their Part D Plan for a

Select one of the following:

  • Month

  • Rolling Year

  • Fiscal Year

  • Calendar Year

  • Rolling Month

Explanation

Question 21 of 31

1

__________ begins 3 months beofre the beneficiary turns 65.

Select one of the following:

  • ICEP

  • AEP

  • ADP

  • ADT

  • ICP

  • ABE

Explanation

Question 22 of 31

1

A Medigap plan can be based on what three different pricing methodologies?

Select one of the following:

  • Attained Age, Age-in, and Communal Age Rated

  • Community, Issue Age, and Attained Age Rated

  • Attained Age, Issue Age, Communal Age Rated

  • None of The Above

  • Community, Standard Age, and Attained Age Rated

Explanation

Question 23 of 31

1

______________ begins October 15 and ends Dec 7 each year.

Select one of the following:

  • GDP

  • AEP

  • GOP

  • ADP

  • ICEP

Explanation

Question 24 of 31

1

Initial Coverage Limit - Member pays 25% of drug cost after deductible is met and UNTIL the retail cost of the drugs equals

Select one of the following:

  • $3210

  • $3310

  • $3410

  • $4850

Explanation

Question 25 of 31

1

2015 Medicare Part B annual deductible is __________?

Select one of the following:

  • $137

  • $187

  • $147

  • $157.50

Explanation

Question 26 of 31

1

Medicare Part D will not cover Drugs covered by Medicare Part B.

Select one of the following:

  • True
  • False

Explanation

Question 27 of 31

1

What are three different plan structures with a Medigap plan?

Select one of the following:

  • A Standard, Select, and Low Deductible plan.

  • A Standard, Select, and High Deductible plan.

  • A Select, Superior, High Deductible plan.

  • A Deductible, Superior, and Select plan.

Explanation

Question 28 of 31

1

_____________ ends February 14

Select one of the following:

  • ADT

  • ADP

  • DOI

  • ACP

  • GEP

Explanation

Question 29 of 31

1

Beneficiaries who did not sign up for Part B when they were first eligible for Medicare may enroll in Part B during the __________.

Select one of the following:

  • GOP

  • AEP

  • GEP

  • ADP

  • ICEP

Explanation

Question 30 of 31

1

Medicare Part A Deductible is ______________?

Select one of the following:

  • $1270

  • $1260

  • $1360

  • $147

Explanation

Question 31 of 31

1

During the Coverage Gap, a beneficicary will pay _______ of the retail cost for generic medications, ________ of the retail cost for brand name medications.

Select one of the following:

  • 65 / 45

  • 58 / 45

  • 45 / 65

  • 25 / 45

Explanation