HC Medicare Basics Test Questions And Answers Verified 100% Correct

HC Medicare Basics Test Questions And Answers Verified 100% Correct A consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for ______________. - answers-63 or more continuous days How does a consumer who qualifies for Low Income Subsidy receive financial assistance for their part of Medicare Part D costs? - answers-Through subsidies such as lower or no monthly plan premiums and lower or no copayments Formulary is defined as: - answers-A list of medications covered within the benefit plan, based on CMS guidelines and developed in collaboration with physicians and pharmacists. Which of the following are true about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Plans and the impact to Plans C and F? (Select 2) - answersConsumers eligible for Medicare Part A on or after January 1, 2020, will not be able to purchase Medicare Supplement Insurance Plans C or F. Consumers eligible for Medicare Part A before January 1, 2020, can enroll in Plan C or F even after 2020 and can keep their plans as long as they choose. Which statement is true about the Medicare Advantage (MA) Out-of-Pocket Maximum? - answers-All MA plans have an Out-of-Pocket Maximum to help limit the member's outof pocket costs for Medicare-covered services Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enroll in an MA Plan? - answers-Medicare Supplement Insurance cannot be used in conjunction with an MA Plan; therefore, after receiving confirmation of enrollment into the MA Plan, the member must cancel their Medicare Supplement Insurance policy according to their carrier's rules. Aside from a stand-alone Medicare Prescription Drug Plan, how else could a Medicareeligible consumer get Part D prescription drug coverage? - answers-They could enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverage. Which of these statements is true about the drug utilization management (UM) rules? - answers-Prior authorization, quantity limit, and step therapy are some examples of the UM rules Which of the following best describes the Late Enrollment Penalty (LEP) - answers-The amount added to the member's monthly plan premium if they did not enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for 63 or more continuous days. Medications that are covered in a Plan's formulary have various levels of associated member cost-sharing (copayments or coinsurance). What are these drug levels called? - answers-Drug Tiers Milton is retiring on his 65th birthday. He is eligible for Medicare and already receives Social Security benefits. How does he enroll in Original Medicare? - answers-His enrollment in Medicare Parts A and B is generally automatic if he meets all eligibility requirements Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to enroll in a Medicare Supplement Insurance Plan? - answers-When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA plan. Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months, and being any age with ESRD or ALS are each eligibility requirements for which program? - answers-Original Medicare Which of the following defines a Medicare Advantage (MA) Plan? (Select 3) - answersAn MA Plan is a health plan option approved by Medicare and offered by private insurance companies, An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often includes Medicare prescription drug coverage (Part D), An MA Plan is part of Medicare and is also called Part C. Janice wants to enroll in a Medicare Advantage plan. Which of the following is NOT an eligibility requirement? - answers-Resides in the plan's service area Which of the following is NOT a correct statement about in-network provider services? - answers-HMO-POS Plans only cover in-network services.