2015 Cdphp

30 Questions

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Matter Quizzes & Trivia

Questions and Answers
  • 1. 
    CDPHP’s Medicare Advantage plans have a yearly deductible.
    • A. 

      Yes – members must pay $147 each year

    • B. 

      No – There are no deductibles on any CDPHP individual Medicare Advantage plans

  • 2. 
    On the 2015 Basic RX (HMO) Plan, the inpatient hospital copay is __________:
    • A. 

      $275 per admission

    • B. 

      $275/day (Days 1-5) & $0/day (Days 6+)

    • C. 

      $400 per admission

    • D. 

      $700 per admission

  • 3. 
    The premium for Core RX (PPO) is _______:
    • A. 

      $134.50

    • B. 

      $138.00

    • C. 

      $194.50

    • D. 

      $276.50

  • 4. 
    A person on Choice Rx (HMO) undergoing therapeutic radiology treatments will pay what amount for each treatment?
    • A. 

      $20

    • B. 

      $25

    • C. 

      $40

    • D. 

      $60

  • 5. 
    If a member goes to an out-of-network specialist on the Core RX (PPO) plan the copay is ________: 
    • A. 

      $30

    • B. 

      $40

    • C. 

      $50

    • D. 

      $60

  • 6. 
    The emergency room copay for Choice RX (HMO) is _______?
    • A. 

      $35

    • B. 

      $40

    • C. 

      $50

    • D. 

      $65

  • 7. 
    Included in CDPHP’s Health and Wellness Programs are:
    • A. 

      Complementary & Alternative Medicine (CAM)

    • B. 

      Health Coach Connection

    • C. 

      Senior Fit

    • D. 

      All of the above

  • 8. 
    The premium for CDPHP’s Basic RX (HMO) Plan is ________?
    • A. 

      $29.50

    • B. 

      $40.00

    • C. 

      $45.50

    • D. 

      $95.50

  • 9. 
    The Choice (HMO) Plan is the only CDPHP Medicare Advantage (HMO/PPO) plan without drug coverage?
    • A. 

      True

    • B. 

      False

  • 10. 
    The premium for Prime Rx (PPO) is  ________:
    • A. 

      $134.50

    • B. 

      $138.00

    • C. 

      $194.50

    • D. 

      $276.50

  • 11. 
    The copay for ambulance services on the Basic Rx (HMO) plan is _______:
    • A. 

      $50

    • B. 

      $125

    • C. 

      $175

    • D. 

      $225

  • 12. 
    The monthly premium for Choice (HMO) is _______:
    • A. 

      $29.50

    • B. 

      $32.00

    • C. 

      $40.00

    • D. 

      $45.50

  • 13. 
    On the Choice Rx (HMO) plan the member will pay how much for a Part B drug:
    • A. 

      20% coinsurance

    • B. 

      $0 copayment

    • C. 

      $35 copayment

    • D. 

      $40 copayment

  • 14. 
    The copay for an x-ray on the Value RX (HMO) plan is _______:
    • A. 

      $0

    • B. 

      $25

    • C. 

      $30

    • D. 

      $60

  • 15. 
    The inpatient hospital out-of-network copay for Classic Rx (PPO )is ________:
    • A. 

      $400

    • B. 

      $600

    • C. 

      $1,000

    • D. 

      $1,200

  • 16. 
    The urgent care copay for Prime Rx (PPO) is ________:
    • A. 

      $35

    • B. 

      $50

    • C. 

      $65

    • D. 

      $75

  • 17. 
    On the Core Rx (PPO) plan, the in-network copay for chiropractic services is _________:
    • A. 

      $15

    • B. 

      $20

    • C. 

      $40

    • D. 

      $60

  • 18. 
    The copay for an outpatient surgery performed in an ambulatory surgical center under the Choice Rx (HMO) plan would be:
    • A. 

      $100

    • B. 

      $125

    • C. 

      $150

    • D. 

      $175

  • 19. 
    What will a member pay for a routine hearing exam under the Basic RX (HMO) plan?
    • A. 

      $20

    • B. 

      $30

    • C. 

      $40

    • D. 

      $50

  • 20. 
    Senior Fit is a no-cost program that includes access to the Silver Sneakers program for all of our Medicare Advantage members.
    • A. 

      True

    • B. 

      False

  • 21. 
    The initial coverage level for Part D prescription drug coverage is _______:
    • A. 

      $2,850

    • B. 

      $2,930

    • C. 

      $2,960

    • D. 

      $4,700

  • 22. 
    On the Choice Rx (HMO) plan a member will pay what amount for a 30-day supply of a Tier 3 Preferred Brand drug in the Initial Coverage Level?
    • A. 

      $11

    • B. 

      $40

    • C. 

      $45

    • D. 

      $95

  • 23. 
    On the Core Rx (PPO) plan a member will pay what amount for a 90-day supply of a Tier 4 Non-Preferred Brand drug in the coverage gap or donut hole?
    • A. 

      $45

    • B. 

      $95

    • C. 

      45% of retail cost of the drug

    • D. 

      65% of retail cost of the drug

  • 24. 
    When a member reaches Catastrophic coverage, in any of CDPHP’s Medicare Advantage plans, what amount will they pay for a generic or multi-source drug?
    • A. 

      $0

    • B. 

      5% or $2.65 whichever is less

    • C. 

      5% or $2.65 whichever is greater

    • D. 

      $6.60

  • 25. 
    On the Prime Rx (PPO) plan, what will the member pay for a 90-day supply purchased through mail order for a Tier 2 Non-Preferred generic drug while in the coverage gap?
    • A. 

      $0

    • B. 

      $8

    • C. 

      $16

    • D. 

      $24

  • 26. 
    What will a member pay on Value Rx (HMO) for a 90 day supply of a Tier 5 specialty drug?
    • A. 

      30% of the retail cost

    • B. 

      33% of the retail cost

    • C. 

      100% of the retail cost

    • D. 

      Tier 5 drugs are not available in a 90 day supply

  • 27. 
    The Catastrophic level of coverage is reached when what dollar amount is paid by the member, or on the member’s behalf, towards the cost of their Part D medications?
    • A. 

      $4,500

    • B. 

      $4,550

    • C. 

      $4,700

    • D. 

      $6,000

  • 28. 
    A member who qualifies for a 75% subsidy will pay what amount for a Tier 3 drug on the Choice RX (HMO) plan during the Initial Coverage Level:
    • A. 

      $12

    • B. 

      $45

    • C. 

      15% or $45 whichever is less

    • D. 

      $95

  • 29. 
    Mr. Foster has both Medicare and Medicaid (dual eligible) and is concerned about drug costs as one of his drugs is a Tier 5.  Under the CDPHP Value RX (HMO) plan, what is the most Mr. Foster will pay for this drug?
    • A. 

      $0 copayment

    • B. 

      $6.60 copayment

    • C. 

      45% coinsurance

    • D. 

      72% coinsurance

  • 30. 
    On the Classic Rx (PPO) plan the member will pay how much for a chemotherapy drug out-of-network?
    • A. 

      20% coinsurance

    • B. 

      $0 copayment

    • C. 

      $35 copayment

    • D. 

      $40 copayment