BCBS OF CA | QUESTIONS WITH VERIFIED CCURATE
ANSWERS| LATEST UPDATED
What sets Blue Shield of California apart from other healthcare plans? - Answers -We
are proud to be part of a non-profit company that has served Californians for over 80
years. At Blue Shield of California, we are constantly innovating to transform our
healthcare system so all Californians can access the personalized affordable, and high-
quality care they deserve.
What is the timeframe for a Health Plan to decide about payment for medical care or
services a member has received? - Answers -60 days
Effective January 1, 2025, the following changes were made to dual eligible enrollment
options in the state of California: - Answers -Both Answers are correct:
Enrolling in a MA (Medicare Advantage) or D-SNP in select counties will trigger
automatic matching Medi-Cal enrollment.
Dual eligible beneficiaries can elect to enroll in a non-SNP MA plan during AEP only.
Inflation Reduction Act caps out-of-pocket costs for Covered Insulin cost sharing: -
Answers -At a maximum of $35 copay per month's supply and applies to non-LIS
beneficiaries throughout the deductible and initial coverage limit
If Blue Shield denies a formulary exception request, the beneficiary is unable to appeal
the decision. - Answers -False
The amount a beneficiary pays for a prescription depends on the type of drug and its
applicable cost-sharing tier. - Answers -True
Appeals and Grievances are the two different types of complaints a beneficiary can
make. - Answers -True
Blue Shield of California offers Medicare Advantage PPO plans in: - Answers -Both
answers are correct:
Northern California in select counties
Southern California in select counties
A marketing/sales event cannot be held within _ hours of an educational event, at the
same location. - Answers -12 Hours
Sales Agents/ Brokers must be trained and tested on Medicare rules, regulations, and
on details specific to the plan products that they sell: - Answers -Annually
Non-Medicare covered vision benefits are: - Answers -Included with Blue Shield
Medicare Advantage Plans (MAPD)
ANSWERS| LATEST UPDATED
What sets Blue Shield of California apart from other healthcare plans? - Answers -We
are proud to be part of a non-profit company that has served Californians for over 80
years. At Blue Shield of California, we are constantly innovating to transform our
healthcare system so all Californians can access the personalized affordable, and high-
quality care they deserve.
What is the timeframe for a Health Plan to decide about payment for medical care or
services a member has received? - Answers -60 days
Effective January 1, 2025, the following changes were made to dual eligible enrollment
options in the state of California: - Answers -Both Answers are correct:
Enrolling in a MA (Medicare Advantage) or D-SNP in select counties will trigger
automatic matching Medi-Cal enrollment.
Dual eligible beneficiaries can elect to enroll in a non-SNP MA plan during AEP only.
Inflation Reduction Act caps out-of-pocket costs for Covered Insulin cost sharing: -
Answers -At a maximum of $35 copay per month's supply and applies to non-LIS
beneficiaries throughout the deductible and initial coverage limit
If Blue Shield denies a formulary exception request, the beneficiary is unable to appeal
the decision. - Answers -False
The amount a beneficiary pays for a prescription depends on the type of drug and its
applicable cost-sharing tier. - Answers -True
Appeals and Grievances are the two different types of complaints a beneficiary can
make. - Answers -True
Blue Shield of California offers Medicare Advantage PPO plans in: - Answers -Both
answers are correct:
Northern California in select counties
Southern California in select counties
A marketing/sales event cannot be held within _ hours of an educational event, at the
same location. - Answers -12 Hours
Sales Agents/ Brokers must be trained and tested on Medicare rules, regulations, and
on details specific to the plan products that they sell: - Answers -Annually
Non-Medicare covered vision benefits are: - Answers -Included with Blue Shield
Medicare Advantage Plans (MAPD)
