2015 Medical Associates - #1 Test

20 Questions | By Bthorup | Updated: Mar 18, 2022 | Attempts: 761

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Questions and Answers

1.

MAHP has what type of contract with the Centers for Medicare and Medicaid Services (CMS):
- A.
  
  Cost
- B.
  
  Private Fee for Service
- C.
  
  Medigap
- D.
  
  No Contract
2.

The MAHP Cost Plan member must continue to pay the Medicare Part B premium in addition to the MAHP plan premium
- A.
  
  True
- B.
  
  False
3.

MAHP only can accept premium payment methods except:
- A.
  
  Automatic withdrawal from a checking account
- B.
  
  Coupon booklet
- C.
  
  Automatic withdrawal from a savings account
- D.
  
  Credit Card
4.

An application can be completed and submitted more than 90 days prior to the effective date.
- A.
  
  True
- B.
  
  False
5.

If a member has the MAHP Community Plan, the office visit copayment with a network physician is:
- A.
  
  $0
- B.
  
  $10
- C.
  
  $15
- D.
  
  $20
6.

For a beneficiary to be effective by the first of one month, what is the submission cut-off date?
- A.
  
  1st of the month
- B.
  
  15th of the month
- C.
  
  25th of the month
- D.
  
  Last working day of the preceding month
7.

If MAHP receives an enrollment form on the 1st of a month (i.e. Nov 1st) with a requested effective date of the current month (i.e. Nov 1^st), the member’s coverage can start on the requested effective date.
- A.
  
  True
- B.
  
  False
8.

MAHP Cost Plan members can change to another MAHP plan for the first of any month provided a new enrollment form is completed by the last working day of the preceding month.
- A.
  
  True
- B.
  
  False
9.

MAHP’s Service Area is approximately a 60 mile radius of Dubuque, Iowa and is licensed in only certain counties in Iowa, Illinois and Wisconsin.
- A.
  
  True
- B.
  
  False
10.

MAHP is local health plan which is owned and operated by the physicians of Medical Associates Clinic.
- A.
  
  True
- B.
  
  False
11.

Under all three MAHP plans, the following services are eligible above and beyond Medicare with a network provider:
- A.
  
  1 routine eye exam per calendar year
- B.
  
  6 routine podiatry visits per calendar year
- C.
  
  1 routine hearing exam per calendar year
- D.
  
  All of the above
12.

Under the Freedom Plan, a same day surgery service received out-of-network would have the following copay:
- A.
  
  $0 copay
- B.
  
  $15 copay
- C.
  
  $75 copay
- D.
  
  $100 copay
13.

MAHP covers emergency services for beneficiaries if they travel both within the U.S. and outside the United States.
- A.
  
  True
- B.
  
  False
14.

In an urgent or emergent situation when the beneficiary is out of the MAHP Service Area, the beneficiary should seek care at the nearest facility and call the MAHP Health Care Services Department after seeking care to report the out of area emergency.
- A.
  
  True
- B.
  
  False
15.

Prescription Drug coverage is available with MAHP Freedom Plan:
- A.
  
  True
- B.
  
  False
16.

If a beneficiary is covered under the MAHP SmartPlan and sees a physician who is not in the network and did not have any authorized referral, the beneficiary would have Original Medicare cost sharing on this claim.
- A.
  
  True
- B.
  
  False
17.

The office visit copay for a MAHP Freedom Plan beneficiary who chooses to go out of network would be:
- A.
  
  $0
- B.
  
  $10
- C.
  
  $15
- D.
  
  $25
18.

Cost Plan beneficiaries are not locked into a plan for the calendar year.
- A.
  
  True
- B.
  
  False
19.

As a CMS 5 Star Plan, MAHP can enroll a beneficiary who is in a non 5 Star Plan to a MAHP Plan using the Special Enrollment Period (SEP).
- A.
  
  True
- B.
  
  False
20.

MAHP Medicare Plans cover hearing aids.
- A.
  
  True
- B.
  
  False