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MEDICARE C E EXAM WITH CORRECT ANSWERS

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MEDICARE C E EXAM WITH CORRECT ANSWERS 1. 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: - Selling DSNPs 2. The consumer states they currently pay a percentage of charges when they receive medical care. This means: - WRONG - The consumer is enrolled in a Medicare Supplement Insurance Plan. 3. Which of the following consumers is best suited for a CSNP? - Mary, who has been seeing a specialist for a qualifying chronic condition 4. 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? - DURING OPEN OR ANNUAL 5. Which is a service provided to a CSNP or DSNP member placed in the low to moderate care management risk level? - ALL of the responses 6. It is very important for consumers enrolling in a CSNP to know the following about accessing providers: - 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. 7. Which statement is true about the Medicaid program? - It helps pay medical costs for certain groups of people with limited income and resources. 8. Which statement is true of DSNP members? - 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. 9. Using the post-enrollment method, when will a new member be disenrolled from their CSNP if a qualifying condition cannot be verified? - 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

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MEDICARE C E EXAM WITH CORRECT ANSWERS

1. 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: - Selling DSNPs



2. The consumer states they currently pay a percentage of charges when they receive medical
care. This means: - WRONG - The consumer is enrolled in a Medicare Supplement Insurance
Plan.



3. Which of the following consumers is best suited for a CSNP? - Mary, who has been seeing a
specialist for a qualifying chronic condition



4. 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? - DURING
OPEN OR ANNUAL



5. Which is a service provided to a CSNP or DSNP member placed in the low to moderate care
management risk level? - ALL of the responses



6. It is very important for consumers enrolling in a CSNP to know the following about accessing
providers: - 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.



7. Which statement is true about the Medicaid program? - It helps pay medical costs for certain
groups of people with limited income and resources.



8. Which statement is true of DSNP members? - 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.

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