a consumer currently has original Medicare and is enrolled in a stand alone prescription drug plan what will happen if the consumer enrolls in an MA plan
... [Show More] that has integrated prescription drug coverage
the consumer will be automatically disenrolled from the standalone PDP upon in Roman in the MA plan that has integrated prescription drug coverage
aside from a standalone Medicare prescription drug plan how else could a Medicare eligible consumer get Part D prescription drug coverage
they can enroll in a Medicare Advantage plan or other Medicare health plan that includes prescription drug coverage
which of the following statements is not true about the coverage gap
all members reach the coverage gap
which of these statements is true about the drug utilization management UN rules
prior authorization quantity limit and step therapy are some examples of the coverage rules
how does a consumer who qualifies for low income subsidy receive financial assistance through their part of Medicare Part D costs
through subsidies such as lower or no monthly plan premiums an lower or no copayments
which of the following list drug tiers from least expensive cost share to most expensive cost share
preferred generics generics preferred brand nonpreferred drug specialty
which of the following is true about Medicare supplement insurance plans
plan benefit amounts automatically update when Medicare changes cost sharing amounts such as deductibles coinsurance and copayments
which definition best describes Medicare Part A
the part of Medicare that helps with the cost of inpatient hospital stays it also helps with Hospice care and some skilled care for homebound
which statement is true about members of a Medicare Advantage plan who wants to enroll in a Medicare supplement insurance plan
the consumer must be in a valid MA election or disenrollment.
Who is eligible for Medicare
consumers age 65 or older consumers under 65 years of age with certain disabilities and consumers of all ages with ESRD or a LS
which of the following defines a Medicare Advantage plan select two
MA plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage
MA plans must provide benefits equivalent to original Medicare and most plans also offer additional benefits
to be eligible for this plan type consumers must meet the following requirements entitled to Medicare Part A and enrolled in Part B reside in the planned service area which plan is described
Medicare Advantage
Which type of MA plan is an HMO plan that also covers some benefits out of network generally at a higher cost
point of service POS plan
when is Marys Medicare supplement open enrollment period if she turns 65 on September 23rd 2019 and her Medicare Part B effective date is September 1st 2019
September 2019 through February 2020
a consumer with original Medicare might be interested in an MA plan because
MA plans typically provide additional coverage beyond original Medicare and often have established copayments for some benefits
which of the following statements is true about a Medicare supplement insurance plan member who wants to enroll in an MA plan
Medicare supplement insurance cannot be used in conjunction with an MA plan therefore after receiving confirmation of enrollment into the MA plan the member should submit to their Medicare supplement insurance carrier a written request to cancel his/her policy
which of the following statements does not correctly define prescription drug stages
a deductible and the amount the member must pay for every prescription medication regardless of what stage they are in
a consumer may have to pay a late enrollment penalty if they did not enroll in a Medicare Advantage plan with the Part D benefits or stand alone prescription drug plan when they were first eligible for Medicare parts A and or Part B or win without credible prescription drug coverage for
63 continuous days or more
being 65 or older being under 65 years of age with certain disabilities for more than 20 four months and being any age with E SRD or LS or each eligibility requirements for which program
original Medicare
which of the following defines a medical advantage MA plan select two
MA plans or health plan options approved by Medicare and offered by the Centers for Medicare and Medicaid Services CMS
MA plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage
member Doug enrolled in a health maintenance organization HMO MA plan he saw an out of network doctor and received a bill for the entire cost of the visit Doug called Medicare to complain and stated that he was never told about these types of costs what should the agent and explain better to Doug when he was enrolled in the plan select three
that dog must receive coverage services from contract in network providers
that in most cases Doug will pay the entire cost of the service if he sees an out of network provider
that exceptions to the provider network requirement are emergency visits urgent care and rental dialysis services which can be obtained from out of network providers
a consumer with original Medicare might be interested in an MA plan because
MA plans typically provide additional coverage beyond original Medicare and often have established copayments for some benefits [Show Less]