Aetna Exam #2

Dashboard My courses Individual MA/MAPD/DSNP - Mastery Test 2023 2023 Individual MA/MAPD/DSNP - Mastery Test Started on Sunday, July 3, 2022, 5:15 PM State Finished Completed on Sunday, July 3, 2022, 5:21 PM Time taken 6 mins 12 secs Points 20/20 Grade 100 out of 100 Feedback Congratulations! You have passed the test with a perfect score! Question 1 Correct Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a person to use only network providers? (Excluding emergency or urgently needed services) a. PDP plan b. HMO plan c. PPO plan d. ESRD plan Your answer is correct. Question 2 Correct What is a Dual eligible Special Needs Plan (D-SNP)? a. A type of Medicare Advantage Prescription Drug (MAPD) coordinated care plan that limits enrollment to people with specific diseases or characteristics. b. An MA plan that tailors benefits, provider choices, and drug formularies to meet specific needs of the groups they serve. c. An MA plan for those who are eligible for Medicare and Medicaid. d. A MA plan required to contract with a state Medicaid agency. e. All of the above Your answer is correct. Question 3 Correct Which of the following is true for Low Income Subsidy? a. Beneficiaries pay no more than $3.95 for a covered generic and $9.85 for each brand name drug b. There is no coverage gap c. There is no Late Enrollment Penalty d. All of the above Your answer is correct. Question 4 Correct Which are attributes of the Aetna's Model of Care? a. An Interdisciplinary Care Team approach b. Clinical programs to improve health and well-being c. Transition of Care Program d. A and B e. All of the above. Your answer is correct. Question 5 Correct 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 Your answer is correct. Question 6 Correct Which of the following statements are true? a. If PPO members see a doctor who is not in the network their cost share for services may be higher b. In the Aetna Medicare 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 Your answer is correct. Question 7 Correct You can find a quick list of tools for Aetna Medicare plans on www.aetnamedicare.com/brokers, which includes information about plans, medications, and doctors, Select one: True False Question 8 Correct Low Income Subsidy (LIS) is a Federal program that helps eligible beneficiaries with their Part D drug costs. Select one: True False Question 9 Correct The difference between LIS and the Medicare Savings Program (MSP) is LIS helps reduce prescription drug costs and MSP helps with Medicare plan premiums, as well as deductibles, copayments and coinsurance associated with medical services. Select one: True False Question 10 Correct D-SNP plans are for only Medicare beneficiaries that need help with Medicare premiums Select one: True False Question 11 Correct LIS Medicare drug plan premium and deductible costs are based on income level. Select one: True False Question 12 Correct The difference between LIS and the Medicare Savings Program (MSP) is that LIS helps reduce prescription drug costs while MSP helps with Medicare plan premiums, deductibles, and copaynents/coinsurance associated with medical services. Select one: True False Question 13 Correct One of Aetna's Model of Care goals is to improve use of preventive health services. Select one: True False Question 14 Correct The DSNP care team helps to coordinate all Medicare and Medicaid covered care and services that the member needs, Select one: True False Question 15 Correct Each pharmacy component of an MAPD plan consists of a formulary, a pharmacy network and benefit designs (cost sharing and tier structure). Select one: True False Question 16 Comect Aetna Medicare Case Management has teams of registered nurses, social workers, behavioral health professionals, and pharmacists who help members navigate the health care system and access services, Select one: True False Question 17 Conect Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum, Select one: True False Question 18 Correct Aetna Medicare Advantage HMO and PPO plans cover routine preventive care including an annual wellness visit, screening mammograms, and prostate cancer screenings, Select one: True False Question 19 Comect A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy. Select one: True False Question 20 Comect All of our HMO and PPO plans include a maximum out-of-pocket limit. Select one: True False