Medicare CE Questions And Answers With
Complete Solution
Confirming the consumer's Medicaid level and that the consumer is entitled to Medicare Part A and
enrolled in Medicare Part B is a requirement of: Correct Answers: Selling DSNPs
The consumer states they currently pay a percentage of charges when they receive medical care.
This means: Correct Answers: WRONG - The consumer is enrolled in a Medicare Supplement
Insurance Plan.
Which of the following consumers is best suited for a CSNP? Correct Answers: Mary, who has been
seeing a specialist for a qualifying chronic condition
On May 10, Michael meets with an agent and says he is enrolled in another carrier's CSNP due to his
diabetes. When can Michael enroll in a different CSNP that also covers diabetes (his only chronic
condition), assuming he has not moved out of his current plan's service area? Correct Answers:
DURING OPEN OR ANNUAL
Which is a service provided to a CSNP or DSNP member placed in the low to moderate care
management risk level? Correct Answers: ALL of the responses
It is very important for consumers enrolling in a CSNP to know the following about accessing
providers: Correct Answers: Some CSNPs are Preferred Provider Organization (PPO) or Point of
Service (POS) Plans that allow members to see out-of-network providers, generally with higher cost
sharing.
Which statement is true about the Medicaid program? Correct Answers: It helps pay medical costs for
certain groups of people with limited income and resources.
Which statement is true of DSNP members? Correct Answers: Members who are QMB+ or are Full
Dual-Eligible are not required to pay copayments for Medicare-covered services obtained from a
DSNP in-network provider. Their provider should bill the state Medicaid program, as appropriate, for
these costs.
Using the post-enrollment method, when will a new member be disenrolled from their CSNP if a
qualifying condition cannot be verified? Correct Answers: WRONG - At the end of the first month of
enrollment
WRONG - 30 days after the last attempt to contact the provider
WRONG - After a 6 month grace period
Members who lose their eligibility for the DSNP due to a change or loss of Medicaid status are
responsible for what cost sharing? Correct Answers: All, such as premiums, deductibles,
copayments, and coinsurance
What are Dual Special Needs Plans (DSNP)? Correct Answers: Medicare Advantage Plans uniquely
designed for consumers enrolled in both Medicare and Medicaid
Complete Solution
Confirming the consumer's Medicaid level and that the consumer is entitled to Medicare Part A and
enrolled in Medicare Part B is a requirement of: Correct Answers: Selling DSNPs
The consumer states they currently pay a percentage of charges when they receive medical care.
This means: Correct Answers: WRONG - The consumer is enrolled in a Medicare Supplement
Insurance Plan.
Which of the following consumers is best suited for a CSNP? Correct Answers: Mary, who has been
seeing a specialist for a qualifying chronic condition
On May 10, Michael meets with an agent and says he is enrolled in another carrier's CSNP due to his
diabetes. When can Michael enroll in a different CSNP that also covers diabetes (his only chronic
condition), assuming he has not moved out of his current plan's service area? Correct Answers:
DURING OPEN OR ANNUAL
Which is a service provided to a CSNP or DSNP member placed in the low to moderate care
management risk level? Correct Answers: ALL of the responses
It is very important for consumers enrolling in a CSNP to know the following about accessing
providers: Correct Answers: Some CSNPs are Preferred Provider Organization (PPO) or Point of
Service (POS) Plans that allow members to see out-of-network providers, generally with higher cost
sharing.
Which statement is true about the Medicaid program? Correct Answers: It helps pay medical costs for
certain groups of people with limited income and resources.
Which statement is true of DSNP members? Correct Answers: Members who are QMB+ or are Full
Dual-Eligible are not required to pay copayments for Medicare-covered services obtained from a
DSNP in-network provider. Their provider should bill the state Medicaid program, as appropriate, for
these costs.
Using the post-enrollment method, when will a new member be disenrolled from their CSNP if a
qualifying condition cannot be verified? Correct Answers: WRONG - At the end of the first month of
enrollment
WRONG - 30 days after the last attempt to contact the provider
WRONG - After a 6 month grace period
Members who lose their eligibility for the DSNP due to a change or loss of Medicaid status are
responsible for what cost sharing? Correct Answers: All, such as premiums, deductibles,
copayments, and coinsurance
What are Dual Special Needs Plans (DSNP)? Correct Answers: Medicare Advantage Plans uniquely
designed for consumers enrolled in both Medicare and Medicaid
