Which of the following Medigap Plans provide foreign travel emergency health care coverage when you travel outside the U.S.
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
Foreign travel emergency coverage with Medigap policies has a lifetime limit of
$45,000
$70,000
$40,000
$50,000
$60,000
Doctors and hospitals bill Medigap carriers directly.
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
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
PD plans included with Medicare Advantage Plans are similar to Medicare Part D plans.
The ___________ begins when the beneficiary is advised they will be losing group coverage.
GEP
ICEP
AEP
SEP
GDP
HMO stands for?
Hospital Maintenance Organizations
Health Maintenance Organizations
Health Medicare Organizations
Medicare Part C is a
Medigap Plan
Prescription Drug Plan
Medicare Advantage Plan
A Standard Medicare Plan
It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan or a MA
PPO Stands for
Preferred Policy Organization
Preferred Provider Organization
Private Provider Organization
Private Policy Organization
Medigap premiums may increase with a _____________ day advance notice
20
25
35
30
26
40
Other benefits may also be provided with some Medicare Advantage plans such as:
Dental
Accident
Hearing
Health
Vision
Fitness
Silver Sneakers
Private Fee for Service
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.
Medicare Cost plans provide additional coverage to _________to Original Medicare coverage, while Medicare Advantage plans provide __________ coverage that takes place of original medicare coverage.
add-on / replacement
replacement / add-on
replacement / stable
Universal / replacement
PPO Network Types Include
National PPO
Regional PPO
Area PPO
District PPO
Local PPO
Circuit PPO
A Cost plan is
A Medigap Plan
A Medicare Advantage plan
Neither a Medicare Advantage plan or a Medigap Plan
A Special Needs Plan
What is the maximum deductible for Medicare Part D (2016)
260
360
460
480
380
560
To get out of the Coverage Gap the beneficiary must pay ____________ in true out of pocket expenses.
$4050
$4850
$4950
$4750
Formulary drugs must be
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
In most situations, a beneficiary must remain in their Part D Plan for a
Month
Rolling Year
Fiscal Year
Calendar Year
Rolling Month
__________ begins 3 months beofre the beneficiary turns 65.
ADP
ADT
ICP
ABE
A Medigap plan can be based on what three different pricing methodologies?
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
______________ begins October 15 and ends Dec 7 each year.
GOP
Initial Coverage Limit - Member pays 25% of drug cost after deductible is met and UNTIL the retail cost of the drugs equals
$3210
$3310
$3410
2015 Medicare Part B annual deductible is __________?
$137
$187
$147
$157.50
Medicare Part D will not cover Drugs covered by Medicare Part B.
What are three different plan structures with a Medigap plan?
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.
_____________ ends February 14
DOI
ACP
Beneficiaries who did not sign up for Part B when they were first eligible for Medicare may enroll in Part B during the __________.
Medicare Part A Deductible is ______________?
$1270
$1260
$1360
During the Coverage Gap, a beneficicary will pay _______ of the retail cost for generic medications, ________ of the retail cost for brand name medications.
65 / 45
58 / 45
45 / 65
25 / 45