Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a person to use only network providers?
A) PDP plan
B) HMO
... [Show More] plan
C) PPO plan
D) ESRD plan
B) HMO
Which plan type allows members to see preferred doctors in network, doctors out of network and does not require referrals to a specialist?
A) PDP plan
B) Cost plan
C) PPO plan
D) HMO plan
C) PPO
Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they are called MAPD plans.
True or False
True
Aetna case management consists of registered nurses, social workers, behavioral health professionals and pharmacists who help members navigate the health care system and access services.
True or False
True
Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum.
True or False
False
Aetna Medicare Advantage HMO and PPO plans cover routine preventative care including an annual wellness visit, screening mammograms, and prostate cancer screenings.
True or False
True
A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy.
True or False
True
All MAPD plans have a prescription drug component.
True or False
True
Which of the following are true?
A) The PPO plans provide access to services from doctors in the PPO network at a lower out-of-pocket cost.
B) In the Open Access HMO plan, members can go to any Aetna Medicare Plan HMO network doctor they choose for covered services without a PCP referral as long as the doctor is a contracted HMO doctor.
C) All of the Medicare Advantage plans include free monthly fitness club memberships to any facility participating within the SilverSneakers network.
D) All of the above
D) All of the above
You can find a quick list of tools for Aetna Medicare plans on www.aetnamedicare.com/brokers which includes information about plans, medications, and doctors.
True or False
True
What is a Dual eligible Special Needs Plan (D-SNP)?
A) A type of MAPD plan designed to provide targeted care and services to individuals with specific needs.
B) A MA plan that tailors benefits, provider choices and drug formularies to meet specific needs of the groups they serve.
C) A MA plan for those who are eligible for Medicare and Medicaid.
D) A MA plan required to contract with a state Medicaid agency.
E) All of the above
E) All of the above
Low Income Subsidy (LIS) is a Medicare financial assistance program that helps to reduce prescription drug costs.
True or False
True
The difference between LIS and the Medicare Savings Program (MSP) is LIS helps reduce prescription drug costs and MSP helps with Medicare plan premiums, deductibles and copayments/coinsurance with medical services.
True or False
True
Which of the following is true for LIS?
A) Beneficiaries pay no more than $3.60 for a covered generic and $8.95 for each brand name drug.
B) There is no coverage gap
C) There is no Late Enrollment Penalty
D) All of the above
D) All of the above [Show Less]