2015 Medical Associates - #1 Test

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1/20 Questions

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

About This Quiz

The 2015 Medical Associates - #1 Test focuses on the operational aspects of Medicare and Medicaid plan management within MAHP. It assesses knowledge on contract types, payment methods, application timings, and member copayments, essential for professionals managing or studying healthcare plans.

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Current Version
Mar 18, 2023

Quiz Edited by
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Aug 11, 2014

Quiz Created by
Bthorup

2015 Medical Associates - #1 Test

MAHP has what type of contract with the Centers for Medicare and Medicaid Services (CMS):

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The MAHP Cost Plan member must continue to pay the Medicare Part B premium in addition to the MAHP plan premium

MAHP only can accept premium payment methods except:

An application can be completed and submitted more than 90 days prior to the effective date.

If a member has the MAHP Community Plan, the office visit copayment with a network physician is:

For a beneficiary to be effective by the first of one month, what is the submission cut-off date?

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.

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.

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.

MAHP is local health plan which is owned and operated by the physicians of Medical Associates Clinic.

Under all three MAHP plans, the following services are eligible above and beyond Medicare with a network provider:

Under the Freedom Plan, a same day surgery service received out-of-network would have the following copay:

MAHP covers emergency services for beneficiaries if they travel both within the U.S. and outside the United States.

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.

Prescription Drug coverage is available with MAHP Freedom Plan:

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.

The office visit copay for a MAHP Freedom Plan beneficiary who chooses to go out of network would be:

Cost Plan beneficiaries are not locked into a plan for the calendar year.

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).

MAHP Medicare Plans cover hearing aids.

2015 Medical Associates - #1 Test

MAHP has what type of contract with the Centers for Medicare and Medicaid Services (CMS):

Quiz Preview

The MAHP Cost Plan member must continue to pay the Medicare Part B premium in addition to the MAHP plan premium

MAHP only can accept premium payment methods except:

An application can be completed and submitted more than 90 days prior to the effective date.

If a member has the MAHP Community Plan, the office visit copayment with a network physician is:

For a beneficiary to be effective by the first of one month, what is the submission cut-off date?

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 1st), the member’s coverage can start on the requested effective date.

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.

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.

MAHP is local health plan which is owned and operated by the physicians of Medical Associates Clinic.

Under all three MAHP plans, the following services are eligible above and beyond Medicare with a network provider:

Under the Freedom Plan, a same day surgery service received out-of-network would have the following copay:

MAHP covers emergency services for beneficiaries if they travel both within the U.S. and outside the United States.

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.

Prescription Drug coverage is available with MAHP Freedom Plan:

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.

The office visit copay for a MAHP Freedom Plan beneficiary who chooses to go out of network would be:

Cost Plan beneficiaries are not locked into a plan for the calendar year.

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).

MAHP Medicare Plans cover hearing aids.

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.