In which two parts of Medicare is enrollment generally automatic for eligible consumers who are receiving social security benefits, unless they choose to
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Parts A and B
Which statement is true about a member of a Medicare Advantage Plan who wants to enroll in a Medicare Supplement Insurance Plan?
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically unenrolled from their MA plan
Which of the following consumers are eligible for Medicare if other eligibility requirements are met?
Consumers age 65 or older, consumers under age 65 with certain disabilities for more than 24 months, and consumers of all ages with ESRD or ALS
Which of the following defines a Medicare Advantage Plan?
MA plans must provide benefits equivalent to Original Medicare, and most also offer additional benefits
MA plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage
Janice wants to enroll in a Medicare Advantage plan. Which of the following is NOT an eligibility requirement?
Does not have any pre existing conditions, such as diabetes or ESRD
What must be explained to consumers enrolling in an HMO MA plan?
The exception to the provider network requirement is emergency visits, urgent care and renal dialysis services, which can be obtained from out of network providers
They must see contracted network providers in order to receive coverage under the plan
Most benefits are covered out of network but at a higher cost
Which of the following are MA plans that focus on using network providers to maximize the benefits and reduce out of network expenses?
HMO, POS, PPO
When is Mary's Medicare Supplement Open Enrollment period if she turns 65 on September 23, 2021, and her Medicare Part B effective date is September 1, 2021?
Sept 2021 - Feb 2022
Jennifer is enrolling into a Medicare Advantage plan and wants to know what counts toward the out of pocket maximum. Which of the following is accurate?
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Margaret currently has a MAPD plan. What would happen if you enrolled her into a stand alone PDP?
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What is Medicare Part D?
A voluntary program, offered by private insurance companies that are contracted with the federal government, that provides prescription drug coverage for an additional monthly plan premium by
Which of the following is a fact about Medicare Prescription Drug Plan?
To enroll, the consumer must reside in the plans service area
What are two options for Medicare consumers to get Part D prescription drug coverage?
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In what order do the four prescription drug coverage stages occur?
Deductible, initial coverage, coverage gap, catastrophic coverage
Which of these statements is NOT true about the drug utilization management rules?
If the medication has a UM rule, the member will not be able to get that medication
Which of the following lists drug tiers from least expensive cost share to the most expensive cost share?
Preferred Generics, Generics, Preferred Brand, Non Preferred Drug, Specialty
Medications that are covered in a Plans formulary have various levels of associated member cost sharing. What are these drug levels called?
Drug tiers
Which of the following statements is correct about HMO MA Plans?
Members must receive covered services from contracted network providers
Which of the following is NOT a statement about in network provider services?
HMO POS plans only cover in network services
When does Medicare Supplement Open Enrollment take place?
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Jennifer is enrolling into a Medicare Advantage plan wants to know what counts toward the out of pocket maximum. Which of the following is accurate?
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