Which type of MA Plan is an HMO plan that also covers certain benefits out-of-network, gen-
erally at a higher cost? Medicare Supplement Insurance Plan Private Fee-for-Service (PFFS)
Point-of-Service (POS) Plan Preferred Provider Organization (PPO) - ANSWER Preferred
Provider Organization (PPO)
Which statement is true about the MA out-of-pocket maximum? A Medicare Advantage Pre-
scription Drug Plan (MAPD) member's costs for prescription drugs and any benefits not cov-
ered by Original Medicare count toward the out-of-pocket maximum. All MA plans have an
out-of-pocket maximum to help limit the member's out-of-pocket costs for Medicare-cov-
ered medical services. The out-of-pocket maximum amount is determined by Medicare each
year and is the same for all MA plans. - ANSWER All MA plans have an out-of-pocket max-
imum to help limit the member's out-of-pocket costs for Medicare-covered medical services.
Which consumer is eligible for a standalone Medicare Prescription Drug Plan (PDP)? Sharon,
who is not enrolled in Medicare Part A or Medicare Part B, and lives in the plan's service
area. Joseph, who is enrolled in Medicare Part A and Medicare Part B and lives in the plan's
service area. Alice, who is enrolled only in Medicare Part A, but does not live in the plan's
service area. Alvin, who is enrolled only in Medicare Part B, but does not live in the plan's
service area. - ANSWER Joseph, who is enrolled in Medicare Part A and Medicare Part B
and lives in the plan's service area.
In what order do the 3 prescription drug coverage stages occur? Initial Coverage, Deductible,
Catastrophic Coverage Catastrophic Coverage, Initial Coverage, Deductible Deductible, Initial
Coverage, Catastrophic Coverage Deductible, Catastrophic Coverage, Initial Coverage - AN-
SWER Deductible, Initial Coverage, Catastrophic Coverage
Which of the following is true about Medicare Supplement Plans?
They are regulated by the Centers for Medicare & Medicaid Services (CMS). Plan benefit
amounts automatically update when Medicare changes cost sharing amounts, such as de-
ductibles, coinsurance and copayments. They can only be purchased during the Annual
1
erally at a higher cost? Medicare Supplement Insurance Plan Private Fee-for-Service (PFFS)
Point-of-Service (POS) Plan Preferred Provider Organization (PPO) - ANSWER Preferred
Provider Organization (PPO)
Which statement is true about the MA out-of-pocket maximum? A Medicare Advantage Pre-
scription Drug Plan (MAPD) member's costs for prescription drugs and any benefits not cov-
ered by Original Medicare count toward the out-of-pocket maximum. All MA plans have an
out-of-pocket maximum to help limit the member's out-of-pocket costs for Medicare-cov-
ered medical services. The out-of-pocket maximum amount is determined by Medicare each
year and is the same for all MA plans. - ANSWER All MA plans have an out-of-pocket max-
imum to help limit the member's out-of-pocket costs for Medicare-covered medical services.
Which consumer is eligible for a standalone Medicare Prescription Drug Plan (PDP)? Sharon,
who is not enrolled in Medicare Part A or Medicare Part B, and lives in the plan's service
area. Joseph, who is enrolled in Medicare Part A and Medicare Part B and lives in the plan's
service area. Alice, who is enrolled only in Medicare Part A, but does not live in the plan's
service area. Alvin, who is enrolled only in Medicare Part B, but does not live in the plan's
service area. - ANSWER Joseph, who is enrolled in Medicare Part A and Medicare Part B
and lives in the plan's service area.
In what order do the 3 prescription drug coverage stages occur? Initial Coverage, Deductible,
Catastrophic Coverage Catastrophic Coverage, Initial Coverage, Deductible Deductible, Initial
Coverage, Catastrophic Coverage Deductible, Catastrophic Coverage, Initial Coverage - AN-
SWER Deductible, Initial Coverage, Catastrophic Coverage
Which of the following is true about Medicare Supplement Plans?
They are regulated by the Centers for Medicare & Medicaid Services (CMS). Plan benefit
amounts automatically update when Medicare changes cost sharing amounts, such as de-
ductibles, coinsurance and copayments. They can only be purchased during the Annual
1
