Cms Test Calls
Part C and Part D CMS Test Call questions
- 1.What is my total maximum out of pocket cost (MOOP) limit?
- A.
$96.40
- B.
$6,000
- C.
$4,700
- D.
$3,400
- E.
$2,000
- 2.What is my cost sharing amount for renal dialysis services?
- A.
$25
- B.
$23.80
- C.
$50
- D.
None
- 3.How much do I pay for flu shots?
- A.
$25
- B.
$5
- C.
$0
- D.
$10
- 4.My uncle will turn 65 on June 10, 2012. What is the first day he could have coverage with a Medicare Advantage plan?
- A.
June 10, 2012
- B.
June 1, 2012
- C.
July 1, 2012
- D.
August 1, 2012
- 5.In 2013, is Geodon on the formulary with the plan?
- A.
Yes
- B.
No
- 6.My mother uses Donnatal. Is it on your formulary?
- A.
Yes
- B.
No
- 7.My mom wants to get a preventive tetanus shot. She has not been injured. Is a preventive tetanus shot covered by Part D?
- A.
Yes
- B.
No
- 8.Would a copy of a Medicaid card that includes my aunts name and eligibility date be acceptable best available evidence for low income subsidy?
- A.
Yes
- B.
No
- 9.Do my premium payments count toward the coverage gap?
- A.
Yes
- B.
No
- 10.Can I find pharmacy network information on your plan's website?
- A.
No
- B.
Yes
- 11.My father does not get extra help and he is not on medicaid. What is the monthly premium?
- A.
$0 monthly plan premium
- B.
$0 monthly plan premium for plans 001, 002, and 006. For 005 the monthly premium is $24.70.
- C.
$0 monthly plan premium for 001, 002, and 005. The premium for 006 is $24.70.
- D.
The monthly plan premium is $24.70
- 12.What is my part B premium amount?
- A.
$0 premium for all plans
- B.
$98.00 premium amount for all plans
- C.
Most people may the Part B premium of $99.90 each month, depending on the individuals income.
- 13.Does plan 001, 002, 005, or 006 reduce my Part B premium? If so, by how much?
- A.
The plan will reduce the monthly medicare part b premium by up to $98.00 for plan 005 only.
- B.
The plan does not reduce the monthly medicare part b premiums.
- C.
The plan will reduce the monthly medicare part b premium by up to $98.00.
- 14.What is the most that my mother would have to pay for an emergency room visit for plans 001, 005, and 008.
- A.
$0 co-payments for plans 005 and 008.
- B.
$0 co-payments for 001, $25 co-payment for plan 008 and $50 co-payment for 005. Co-payments are waived upon admittance.
- C.
$50 co-payment for all plans and shall be waived upon admittance.
- D.
$25 co-payments for plans 001 and 005 and $0 for plan 008.
- 15.How much do I pay for Chemotherapy Services?
- A.
20% of the cost for Part B-covered chemotherapy drugs
- B.
$0 co-payment
- C.
$50 co-payment
- D.
Not covered by the plan
- 16.What is my cost sharing amount for care at skilled nursing facility?
- A.
$25 copay for 001, 005, 006, 007 with no prior hospital stay required.
- B.
$0 copay for 001, 005, 006, 007 with no prior hospital stay required. Plan 002 and 008 $0 copay per day for 1-6 days, $25 per day for 7-25 days, and $0 per day for 26-100 days.
- C.
$0 with no prior hospital stay required.
- D.
$50 with no prior hospital stay required.
- 17.What is the cost sharing for preventive services that are covered at no cost sharing under Original Medicare for all plans under HealthSun Health plans.
- A.
$30 co-payment
- B.
$25 co-payment
- C.
$0 co-payment
- D.
$50 Co-Payment
- 18.While with HSHP does my dad need a refferal for outpatient diagnostic lab services?
- A.
Yes
- B.
No
- 19.My mother is enrolled in HealthSun Health Plans and wants to know if services provided by a non-network doctor would be covered.
- A.
Non-Network providers will be covered under Emergency/urgent situation. Besides emergencies you must have plan approval.
- B.
Non-network providers are not covered under HSHP.
- 20.What is the maximum amount my dad would have to pay for ambulance services while in HSHP?
- A.
$0 co-payments for 001, 006, 007 and $25 for plans 002, 005 and 008. All co-payments will be waived upon admittance.
- B.
$0 co-payments for all plans
- C.
$50 co-payment
- 21.Does HSHP cover routine eye exams as an optional suppllemental benefit?
- A.
No
- B.
Yes
- 22.Can my dad use a Medigap policy to pay for a Medicare Advantage plan's out-of-pocket costs, like co-payments?
- A.
Yes Medigap policy can be used to pay co-payments as long as he has medicare
- B.
No Medigap policy only works with Original Medicare
- 23.My mother’s health is not so good these days but she really wants to live at home. If she qualifies for home health coverage will the cost of services like cooking and cleaning be covered?
- A.
No the cost for cooking and cleaning will not be covered
- B.
If she qualifies for this service the plan will cover cooking and cleaning
- 24.Does a Medicare Advantage plan cover hospital expenses along with doctor office visit?
- A.
No hospital expenses are not covered
- B.
Yes hospital and doctor visits will be covered
- 25.Does the plan cover Dilantin 100 Mg casules?
- A.
The plan only covers Dilantin 30 mg and 50 mg.
- B.
No the plan does not cover Dilantin
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