Priority Health 2023 Product Certification Exam

Priority Health 2023 Product Certification Exam All 10 Priority Health MAPD plans have no in-network medical deductibles - ✔✔True The Priority Health MAPD network, for the 9 standard plans (non D-SNP), includes: - ✔✔Al ...

Priority Health 2023 Product Certification Exam All 10 Priority Health MAPD plans have no in-network medical deductibles - ✔✔True The Priority Health MAPD network, for the 9 standard plans (non D-SNP), includes: - ✔✔All of the above The "Free to Talk" benefit means a member will not have an office copay for an annual physical exam, even when a diagnostic issue arises during the visit. - ✔✔True The "Flat Fee" for observation means a member will only pay the E.R. copay even if held for observation and other services are rendered. - ✔✔True The Over the Counter (OTC) allowance is available on which of the following plans: - ✔✔Key, Edge, Ideal, Compass, Vital, Value and D-SNP To receive the OTC benefit, Members will need to call and request the dollar amount allowance each quarter. - ✔✔False All 9 standard Priority Health MAPD plans (non D-SNP) include Dental, Vision and Hearing embedded benefits in the medical plan. - ✔✔True All 9 standard Priority Health MAPD plans (non D-SNP) will cover claims outside of Michigan at the in-network benefit level for any Medicare participating provider AND with MultiPlan Medicare providers - ✔✔True All 9 Priority Health Standard MAPD plans (non D-SNP) include "Assist America" emergency travel assistance. - ✔✔True Priority Health optional enhanced Dental and Vision now includes which of the following? - ✔✔All of the above Priority Health MAPD plans offer in-home health assessments at no cost to the member. - ✔✔True The PriorityMedicare Edge PPO plan is ONLY available to beneficiaries residing in Region 5 - ✔✔False All 9 standard Priority Health MAPD plans (non D-SNP) include $0 copay for tier 1&2 90 day supply of mail order drugs. - ✔✔True All 9 standard Priority Health MAPD plans (non D-SNP) include preferred pharmacy copays. - ✔✔True All 10 Priority Health MAPD plans, HMO-POS, PPO and D-SNP, use the same Medicare Advantage Network in Michigan. - ✔✔True All 9 standard Priority Health MAPD plans (non D-SNP) both HMO-POS and PPO plans do NOT require a PCP referral to see an in-network Specialist - ✔✔True Priority Health MAPD Plans Edge, Key, Compass, Vital and Ideal cover 12 routine chiropractic visits per year. - ✔✔True Which of the following is true about the optional Dental/Vision benefit: - ✔✔All of the above Priority Health Medicare D-SNP (HMO) plan includes: - ✔✔All of the above Priority Health Medicare D-SNP (HMO) plan: - ✔✔All of the above Priority Health Medigap plans allow "Fast Track" simplified underwriting for applicants within 3 years of Part B Medicare enrollment. - ✔✔True PriorityMedicare members have in-network benefits, when out of state, when seeing Medicare providers in the MultiPlan Medicare network, or with any Medicare participating provider. - ✔✔True Which plans include Companion Care powered by PAPA? - ✔✔PriorityMedicare Edge, PrioirtyMedicare Compass Plan, PriorityMedicare Ideal and D-SNP only Signify Health provides PriorityMedicare members with a free in-home health assessment for what reason(s)? - ✔✔All of the above Priority MAPD members are eligible for a hearing benefit which includes $0 copay routine hearing exam and tiered copay options for hearing aids. The members can visit any hearing provider to obtain these benefits. - ✔✔False PriorityMedicare has partnered with myStrength, the "health club for your mind" to provide free online access to the following mental wellness tools: - ✔✔All of the Above Acupuncture covers for all Priority Health Medicare members with a $20 copay per session and $0 copay for PriorityMedicare D-SNP members for up to 20 visits for chronic lower back and 6 visits other conditions. - ✔✔True PriorityMedicare Edge plan is a great choice for newly aging-in members and those who want a PPO for a $0 premium in regions 1, 2 & 5. - ✔✔True PriorityMedicare Key plan is a great choice state-wide for newly aging-in members and those who want more embedded dental and insulin coverage in the gap on a $0 premium plan. - ✔✔True PriorityMedicare Vital is geared for people who are on Original Medicare who want extras and a safety net, featuring a 20% coinsurance on most benefits. - ✔✔True The PriorityMedicare Vital (PPO) plan includes a $30 Part B monthly premium reduction ($360/year) - ✔✔True The PriorityMedicare Key plan was enhanced to include which of the following benefits? - ✔✔All of the Above All 10 Priority Health MAPD Plans, HMO-POS, PPO, and D-SNP include up to two weeks of meals following an inpatient hospital stay. - ✔✔True Priority Health D-SNP (HMO) now includes which of the following benefits? - ✔✔All of the Above Priority Health D-SNP (HMO) now includes which of the following embedded comprehensive dental benefits? - ✔✔All of the Above