Questions and answers, 2022/2023 latest
updates.
Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a person to
use only network providers?
A) PDP plan
B) HMO plan
C) PPO plan
D) ESRD plan - ✔✔B) HMO
Which plan type allows members to see preferred doctors in network, doctors out of network and does
not require referrals to a specialist?
A) PDP plan
B) Cost plan
C) PPO plan
D) HMO plan - ✔✔C) PPO
Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they are
called MAPD plans.
True or False - ✔✔True
Aetna case management consists of registered nurses, social workers, behavioral health professionals
and pharmacists who help members navigate the health care system and access services.
, True or False - ✔✔True
Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum.
True or False - ✔✔False
Aetna Medicare Advantage HMO and PPO plans cover routine preventative care including an annual
wellness visit, screening mammograms, and prostate cancer screenings.
True or False - ✔✔True
A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard
pharmacy.
True or False - ✔✔True
All MAPD plans have a prescription drug component.
True or False - ✔✔True
Which of the following are true?
A) The PPO plans provide access to services from doctors in the PPO network at a lower out-of-pocket
cost.
B) In the Open Access HMO plan, members can go to any Aetna Medicare Plan HMO network doctor
they choose for covered services without a PCP referral as long as the doctor is a contracted HMO
doctor.
C) All of the Medicare Advantage plans include free monthly fitness club memberships to any facility
participating within the SilverSneakers network.
D) All of the above - ✔✔D) All of the above