Medicare advantage plan - Study guides, Class notes & Summaries

Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? correct answersDr. Brennan can charge Mary Rogers no more than the cost sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15% of the Medicare rate. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an at...

Ms. Moore plans to retire when she turns 65 in a few months. She is in excellent health and will have considerable income when she retires. She is concerned that her income will make it impossible for her to qualify for Medicare. What could you tell her to address her concern? - Medicare is a program for people 65 or older and those under the age 65 with certain disabilities, end-stage renal disease, and Lou Gehrig's disease so she will be eligible for Medicare. Mr. Schmidt would like to pla...

United Health Care Insurance Exam| Questions and Verified Answers| Grade A (2023/2024 New Update) QUESTION Do consumers have to be an AARP member to enroll in an AARP-branded plan with UnitedHealthcare? Answer: Yes, if the consumer is enrolling in a Medicare Supplement Plan QUESTION How many status levels are in the Authorized to Offer Program? Answer: 2 QUESTION According to AARP, there are how many individual AARP members? Answer: Nearly 37 milli...

Mr. Davis is 52 years old and has recently been diagnosed with end-stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him?correct answersHe may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for several more years at Smallcap, Incorporated. Smallcap has a workforce of15 emplo...

Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say? - ANSWER Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which the individual receives a kidney tr...

2024 Ethics and Compliance Assessment UHC written exam with already passed questions and answers Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? - Answer April 1 through October 31 Which of the following statements is true about using a five star special enrollment period (SEP)? - Answer It can be used once from...

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 M...

The value proposition for the AARP brand is seen in what kinds of benefits for the members? (Select 3) - ANSWERSQuality of products offered. Efforts to improve the lives of members. Security and reputation of the AARP name. Which of the following must you ensure a consumer who is making a plan change understands? (Select 2) - ANSWERSI must make sure the consumer understands the benefits, costs, and limitations of the new plan I must make sure the consumer understands what they are givi...

Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap policy as well, but it provides no drug coverage. She would like to keep the coverage she has but replace her existing Medigap plan with one that provides drug coverage. What should you tell her? correct answersMrs. Gonzalez cannot purchase a Medigap plan that covers drugs, but she could keep her Medigap policy and enroll in a Part D prescription drug plan. Mrs. Chen will be 65 soon, has been a citizen for twelve years, has bee...

When you market Medicare Advantage and Part D plans, what may you offer as a gift to induce enrollment in a plan? You may provide gifts or prizes to all potential enrollees during an event that does not exceed $15 in retail value. By contacting plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefits package. What should you do to make sure yo...