Health Maintenance Organizations

Hospital Maintenance Organizations

Preferred Provider Organization

Neither a Medicare Advantage plan or a Medigap Plan

Medicare Learning

Question 1

Question

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

Answer

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

Question 2

Question

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

Answer

$45,000
$70,000
$40,000
$50,000
$60,000

Question 3

Question

Doctors and hospitals bill Medigap carriers directly.

Answer

True
False

Question 4

Question

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

Answer

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

Question 5

Question

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

Answer

True
False

Question 6

Question

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

Answer

GEP
ICEP
AEP
SEP
GDP

Question 7

Question

HMO stands for?

Answer

Hospital Maintenance Organizations
Health Maintenance Organizations
Health Medicare Organizations

Question 8

Question

Medicare Part C is a

Answer

Medigap Plan
Prescription Drug Plan
Medicare Advantage Plan
A Standard Medicare Plan

Question 9

Question

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

Answer

True
False

Question 10

Question

PPO Stands for

Answer

Preferred Policy Organization
Preferred Provider Organization
Private Provider Organization
Private Policy Organization

Question 11

Question

Medigap premiums may increase with a _____________ day advance notice

Answer

Question 12

Question

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

Answer

Dental
Accident
Hearing
Health
Vision
Fitness
Silver Sneakers

Question 13

Question

Private Fee for Service

Answer

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.

Question 14

Question

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

Answer

add-on / replacement
replacement / add-on
replacement / stable
Universal / replacement

Question 15

Question

PPO Network Types Include

Answer

National PPO
Regional PPO
Area PPO
District PPO
Local PPO
Circuit PPO

Question 16

Question

A Cost plan is

Answer

A Medigap Plan
A Medicare Advantage plan
Neither a Medicare Advantage plan or a Medigap Plan
A Special Needs Plan

Question 17

Question

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

Answer

Question 18

Question

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

Answer

$4050
$4850
$4950
$4750

Question 19

Question

Formulary drugs must be

Answer

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

Question 20

Question

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

Answer

Month
Rolling Year
Fiscal Year
Calendar Year
Rolling Month

Question 21

Question

__________ begins 3 months beofre the beneficiary turns 65.

Answer

ICEP
AEP
ADP
ADT
ICP
ABE

Question 22

Question

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

Answer

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

Question 23

Question

______________ begins October 15 and ends Dec 7 each year.

Answer

GDP
AEP
GOP
ADP
ICEP

Question 24

Question

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

Answer

$3210
$3310
$3410
$4850

Question 25

Question

2015 Medicare Part B annual deductible is __________?

Answer

$137
$187
$147
$157.50

Question 26

Question

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

Answer

True
False

Question 27

Question

What are three different plan structures with a Medigap plan?

Answer

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.

Question 28

Question

_____________ ends February 14

Answer

Question 29

Question

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

Answer

GOP
AEP
GEP
ADP
ICEP

Question 30

Question

Medicare Part A Deductible is ______________?

Answer

$1270
$1260
$1360
$147

Question 31

Question

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

Answer

65 / 45
58 / 45
45 / 65
25 / 45

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Medicare Learning

Description

Resource summary

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6

Question 7

Question 8

Question 9

Question 10

Question 11

Question 12

Question 13

Question 14

Question 15

Question 16

Question 17

Question 18

Question 19

Question 20

Question 21

Question 22

Question 23

Question 24

Question 25

Question 26

Question 27

Question 28

Question 29

Question 30

Question 31

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	Created by Blkstr3600 almost 9 years ago