2015 Bcbs Of Ri

30 Questions

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2015 Bcbs Of Ri

Questions and Answers
  • 1. 
    All of the following services apply towards Out‐of‐Pocket Maximum in 2015 except:a) Hospital Copayment.b) Physician Office Visit copayment.c) Part D Prescription Copayment.d) Skilled Nursing Copayment .e) Dental
    • A. 

      Both A & E

    • B. 

      Both B & C

    • C. 

      B,D & E

    • D. 

      Both C& E

  • 2. 
    What is the copayment for diabetic monitoring supplies on all plans in 2015?
    • A. 

      $40

    • B. 

      20%

    • C. 

      $15

    • D. 

      15%

    • E. 

      $0

  • 3. 
    Anyone can sell the BlueCHiP for Medicare Select plan to new clients in 2015?
    • A. 

      True

    • B. 

      False

  • 4. 
    Which plan(s) below have a $0 monthly premium?A. ValueB. CoreC. PlusD. Select
    • A. 

      Both A & D

    • B. 

      Both B & C

    • C. 

      A Only

    • D. 

      A, B & D

  • 5. 
    The copayment for Lab for BlueChip for Medicare Value, Core, Select & Standard with Drugs is $10 perday?
    • A. 

      True

    • B. 

      False

  • 6. 
    An individual is eligible for BCBSRI’s Medicare plans if they?
    • A. 

      Have Medicare Part A and Part B and continue to pay premiums for A and B where applicable.

    • B. 

      Live in Rhode Island.

    • C. 

      Have had a successful kidney transplant if they have ESRD.

    • D. 

      All of the above.

  • 7. 
    Which of the following is NOT a benefit of the Value Plan?
    • A. 

      Dental

    • B. 

      Vision Hardware.

    • C. 

      Skilled Nursing Facility.

    • D. 

      Routine Vision Exam

  • 8. 
    What is the Outpatient surgery copayment for the Extra plan?
    • A. 

      $125

    • B. 

      $150

    • C. 

      $175

    • D. 

      $200

  • 9. 
    What is the Vision hardware allowance for the Extra plan?
    • A. 

      $100

    • B. 

      $125

    • C. 

      $150

    • D. 

      There isn’t any

  • 10. 
    Which of the following demonstrates the correct copayment amounts for the Select Plan?
    • A. 

      Hospital $285/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $150; Days 46‐100 $0

    • B. 

      Hospital $345/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $155; Days 46‐100 $0

    • C. 

      Hospital $500 per admission; SNF 1‐20 days $30; Days 21‐35 $150; Days 36‐100 $0

    • D. 

      Hospital $750 per admission; SNF 1‐20 days $30; Days 21‐35 $150; Days 36‐100 $0

    • E. 

      None of the above.

  • 11. 
    What is cost sharing for prescription drugs on the Value plan?
    • A. 

      $4/$45/$95/33%

    • B. 

      $0/$45/$95/30% $100 Brand Deductible

    • C. 

      $2/$45/$95/30% $320 Brand Deductible

    • D. 

      $6/$20/$50/25%

  • 12. 
    What is the cost sharing for prescription drugs on the Select plan?
    • A. 

      $0/$24/$52/25% $320 brand deductible

    • B. 

      $3/$10/$45/$95/33%

    • C. 

      $0/$45/$95/28% $200 brand deductible

    • D. 

      $20/$60/$130/25%

  • 13. 
    All BlueCHiP for Medicare options offer vision hardware.
    • A. 

      True

    • B. 

      False

  • 14. 
    A member who utilizes the Living Fit benefit pays a $5 copayment per month and can enroll in multiplehealth clubs at a time?
    • A. 

      True

    • B. 

      False

  • 15. 
    What is the Maximum Out‐of‐Pocket (MOOP) for the Value plan?
    • A. 

      $4,950

    • B. 

      $4,450

    • C. 

      $4,250

    • D. 

      $5,000

  • 16. 
    There is a $65 copayment for Emergency Visits for all BlueCHiP for Medicare Advantage plans?
    • A. 

      True

    • B. 

      False

  • 17. 
    Blue Cross Blue Shield of Rhode Island pharmacy Benefit Manager is Catamaran?
    • A. 

      True

    • B. 

      False

  • 18. 
    In the Select Network, a member will not be able to see any Specialist of their choice?
    • A. 

      True

    • B. 

      False

  • 19. 
    How many Skilled Nursing Facilities are part of the Select Network?
    • A. 

      77

    • B. 

      7

    • C. 

      11

    • D. 

      80

  • 20. 
    Which hospital is not included in the Select Network?
    • A. 

      South County

    • B. 

      Memorial

    • C. 

      Landmark

    • D. 

      Miriam

  • 21. 
    Which Primary Care Physician Groups are part of the Select Network?a) University Medicine Groupb) Rhode Island Primary Physicians Corp.c) Coastal Medical Groupd) Care New Englande) Orthopedic Group of RI
    • A. 

      A, B, C

    • B. 

      B and D

    • C. 

      B and E

    • D. 

      B, C, and D

  • 22. 
    Does the Select plan have a Point‐of‐Service (POS) benefit?
    • A. 

      True

    • B. 

      False

  • 23. 
    What is the inpatient hospital stay for days 1‐5 for the Extra plan?
    • A. 

      $190

    • B. 

      $285

    • C. 

      $350

    • D. 

      $275

  • 24. 
    What is the prescription drug deductible for the Extra plan?
    • A. 

      $200

    • B. 

      $320

    • C. 

      $100

    • D. 

      None

  • 25. 
    Are hearing aids covered on the Extra plan?
    • A. 

      True

    • B. 

      False

  • 26. 
    What is the outpatient surgery cost‐sharing for the Value plan?
    • A. 

      $150

    • B. 

      $175

    • C. 

      20%

    • D. 

      35%

  • 27. 
    What is the inpatient hospital stay for days 1‐5 for the Select plan?
    • A. 

      $275

    • B. 

      $345

    • C. 

      $180

    • D. 

      $285

  • 28. 
    What is the Maximum Out‐of‐Pocket (MOOP) for the Extra?
    • A. 

      $5,000

    • B. 

      $2,800

    • C. 

      $4,250

    • D. 

      $3,750

  • 29. 
    Which plan has prescription drug coverage through the Gap?
    • A. 

      Extra

    • B. 

      Preferred

    • C. 

      Plus

    • D. 

      Select

  • 30. 
    If a member sees a primary care physician outside of the Select network, they would pay a $0 copayment.
    • A. 

      True

    • B. 

      False