1. Medicare - ANS ✔Federal health insurance program
2. Medicare is administered by whom? - ANS ✔CMS
( Centres for Medicare and Medicaid services)
3. Parts A & B of Medicare are - ANS ✔federal health
insurance program referred to as original Medicare
4. Part A? - ANS ✔Hospital insurance
5. Part B? - ANS ✔Medical insurance
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6. What doesn’t Medicare cover? - ANS ✔routine dental, eye
care hearing exam, deductibles, coinsurance and co-
payments
7. Part C? - ANS ✔Medicare Advantage Plans
8. MA covers? - ANS ✔Part A &B coverage, and some part D
coverage
9. MA plans are not? - ANS ✔Medicare supplement insurance
plans
10. What offers lower monthly premiums MADP or
supplement? - ANS ✔MADP
11. do MAP's have a annual maximum OOP maximum
that limits the amount of money a member must spend
every year for covered services? - ANS ✔YES
12. MA plans integrate what type of additional
coverage? - ANS ✔part D prescription drug coverage
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13. If a customer wants to keep their stand alone
prescription drug plan, what may the customer want to
enrol in? - ANS ✔MA-only PFFS plan
14. What is a stand alone drug plan called? - ANS ✔PDP
15. What is PFFS? - ANS ✔Private Fee for Service (PFFS) -
Plans that allow you to go to any doctor or hospital that
accepts their terms
16. If a customer lives in a rural area, what type of plan
may they want because it gives them freedom to access
doctors that may not be in their network? - ANS ✔PFFS
plan
17. Do HMO's require referrals? - ANS ✔Yes
18. Do PPO's require a referral? - ANS ✔No
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19. When a member enrols in a MA plan, they receive
their coverage from Medicare or the MA plan? - ANS
✔MA plan
20. When a customer is enrolled in a MA plan, they
must continue paying their premiums for what other
plan? - ANS ✔Part B
21. MA plans have a maximum annual limit on OOP
costs called a? - ANS ✔MOOP amount ( Maximum out of
pocket)
22. When a member is enrolled in a MA plan, they are
automatically disenrolled from any other MA plan or
PDP( prescription drug plan) in which they are enrolled
as of the new plans_____? - ANS ✔effective date
23. An exception exists for MA-only PFFS plans as a
member can also be enrolled in a what? - ANS ✔Stand
alone PDP
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