If a beneficiary is enrolled in a MA-only PPO and they also sign up for a PDP plan, they will be automatically dropped from their MA plan. - ANSWER True
Which of the following statements regarding eligibility criteria
...
If a beneficiary is enrolled in a MA-only PPO and they also sign up for a PDP plan, they will be automatically dropped from their MA plan. - ANSWER True
Which of the following statements regarding eligibility criteria for Medicare Advantage PPO plans is true?
a. The enrollee must be entitled to Part A and enrolled in Part B
b. The enrollee must reside in the MA plan's service area
c. The 21st Century Cures Act amended the Social Security Act to allow all Medicare-eligible individuals with End Stage Qenal Disease (ESQD)
to enroll in MA plans beginning January 1, 2021
d. All of the above statements are true. - ANSWER d
Emergency care is always considered to be in network. - ANSWER True
Prescription drug costs under Part D do not apply toward the medical out-of-pocket maximum. - ANSWER True
What extra benefits not covered by traditional Medicare MAY be provided by MA-PD plans?
a. Routine vision and hearing exams
b. Fitness benefits
c. Dental benefits
d. All of the above may be extra benefits provided by MA-PD plans - ANSWER d
A copayment is defined as:
a. A fixed dollar amount
b. A percentage
c. A secondary insurance plan
d. None of the above - ANSWER a
A PPO is a plan in which enrollees pay less if they use doctors, hospitals, and providers that belong to the network. Services obtained from doctors,
hospitals and providers outside the network will result in additional costs to the member — unless the services are classified as an emergency. - ANSWER True
Which is NOT considered a preventive benefit?
a. Pap smear
b. Prostate cancer screening exam
c. Mammography screening
d. Chiropractic services - ANSWER d
If during the year, costs for certain services reach the annual out-of-pocket limit amount, the member will not pay any further costs for these network provided covered services for the remainder of the calendar year. - ANSWER True
Which expenses listed below do not apply to the out-of-pocket maximum, even when they are covered?
a. Non-Medicare covered Eye Exams
b. Non-Medicare covered Eye Wear
c. Hearing Aids
d. All of the above - ANSWER d
[Show More]
