2014-adp-qm December Incentive Quiz 2/4-as

10 Questions | Total Attempts: 97

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2014-adp-qm December Incentive Quiz 2/4-as

Questions and Answers
  • 1. 
    What additional benefits must be read if the Customer resides in a nursing home?
    • A. 

      Home Health

    • B. 

      Outpatient Rehabilitation Services

    • C. 

      Skilled Nursing Facility (SNF)

    • D. 

      Long Term Drug Tiers

  • 2. 
    If there is a “no” in a copay field, then that drug tier does not need to be read.
    • A. 

      True

    • B. 

      False

  • 3. 
    When reading the Coverage Gap and the Catastrophic Coverage benefits.  The ADP did not read any of the verbiage in parenthesis. This will be marked down because it must be verbatim.
    • A. 

      True

    • B. 

      False

  • 4. 
    The summary of benefits had additional copays listed in between the Coverage Gap and the Catastrophic Coverage. These copays do not need to be read.
    • A. 

      True

    • B. 

      False

  • 5. 
    When the summary of benefits displays both the Preferred Cost Sharing and the Standard Cost Sharing, which benefits must be read?
    • A. 

      All of them

    • B. 

      Preferred Retail Cost-Sharing and Standard Retail Cost-Sharing

    • C. 

      Standard Retail Cost-Sharing and Standard Mail Order Cost-Sharing

    • D. 

      Preferred Retail Cost-Sharing and Preferred Mail Order Cost-Sharing

  • 6. 
    If enrolling the Customer into a Humana High Deductible Plan F, the only benefit that must be read is “You must pay the first $2,180 (for 2015) in Medicare-covered costs before the Medigap plan pays anything.”
    • A. 

      True

    • B. 

      False

  • 7. 
    When enrolling the Customer into a Plan N, which benefits are required to be read?
    • A. 

      Hospitalization- Covers 100% of Part A coinsurance plus coverage for 365 additional days after Medicare benefits end

    • B. 

      Medical Expenses- Covers 100% of Part B coinsurance after you meet your yearly Part B deductible ($147 for 2015). You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits that don't result in an inpatient admission.

    • C. 

      Coverage while in a foreign county- Covers 80% of medically necessary emergency care services beginning during the first 60 days of each trip outside the USA after you meet the yearly deductible of $250, up to a lifetime maximum of $50,000.

    • D. 

      All of the above

  • 8. 
    When enrolling the Customer into a Select Plan F, which benefits are required to be read?
    • A. 

      Doctor and Hospital Choice- Medicare SELECT is a type of Medigap policy that requires you to use hospitals and, in some cases, doctors within its network to be eligible for full insurance benefits (except in an emergency).

    • B. 

      Hospitalization- Covers 100% of Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.

    • C. 

      Medical Expenses- Covers 100% of Part B coinsurance.

    • D. 

      None of the above because it is a Plan F

  • 9. 
    If an ADP reads a non-required benefit incorrectly, they will not be marked down.
    • A. 

      True

    • B. 

      False

  • 10. 
    On a PDP, if the deductible is $0; then it is acceptable to skip the deductible.
    • A. 

      True

    • B. 

      False

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