2015 Rocky Mountain Health Plans
Questions and Answers
- 1.
RMHP is a Medicare Cost Plan.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
RMHP stands for Rocky Mountain Health Plans, which is a health insurance company based in Colorado. They offer a variety of health insurance plans, including Medicare Cost Plans. Medicare Cost Plans are a type of Medicare health plan that is available in certain areas of the United States. These plans provide coverage for both Medicare Part A and Part B services, and often include additional benefits such as prescription drug coverage. Therefore, the statement that RMHP is a Medicare Cost Plan is true.Rate this question:
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- 2.
Worldwide emergency care is not a RMHP Cost Plan benefit.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The statement is false because worldwide emergency care is indeed a benefit of RMHP Cost Plan.Rate this question:
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- 3.
All Colorado counties are included in RMHP’s service area.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The given statement is false because not all Colorado counties are included in RMHP's service area.Rate this question:
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- 4.
Out-of-Pocket Maximums: Thrifty plan:
- A.
$5,000
- B.
$6,000
- C.
$6,700
Correct Answer
B. $6,000Explanation
The out-of-pocket maximum for the Thrifty plan is $6,000. This means that once an individual or family reaches $6,000 in out-of-pocket expenses, such as deductibles, copayments, and coinsurance, the insurance plan will cover 100% of any additional healthcare costs for the remainder of the plan year. This helps protect individuals and families from excessive financial burdens related to healthcare expenses.Rate this question:
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- 5.
Out-of-Pocket Maximums: Standard plan
- A.
$4,500
- B.
$6,000
- C.
$6,700
Correct Answer
A. $4,500Explanation
The out-of-pocket maximum refers to the maximum amount of money that an individual is required to pay for covered medical expenses in a given year. In this case, the correct answer is $4,500, which means that once an individual has paid a total of $4,500 in out-of-pocket expenses, their insurance plan will cover 100% of any additional costs for covered services. This is the lowest out-of-pocket maximum among the options provided, indicating that it would be the most cost-effective choice for individuals seeking to limit their financial liability for medical expenses.Rate this question:
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- 6.
Out-of-Pocket Maximums: Green plan
- A.
$4,500
- B.
$6,000
- C.
$6,700
Correct Answer
C. $6,700Explanation
The out-of-pocket maximum for the Green plan is $6,700. This means that once an individual or family has paid a total of $6,700 in deductibles, copayments, and coinsurance for covered services, the insurance plan will cover 100% of the remaining costs for the rest of the plan year. This maximum limit helps protect individuals and families from excessive financial burden in case of high medical expenses.Rate this question:
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- 7.
Out-of-Pocket Maximums: Plus plan
- A.
$4,500
- B.
$6,000
- C.
$6,700
Correct Answer
A. $4,500Explanation
The out-of-pocket maximum for the Plus plan is $4,500. This means that once a person has paid $4,500 in out-of-pocket expenses for covered services, their insurance will cover 100% of any additional costs for the remainder of the plan year. This limit helps protect individuals from excessive medical expenses and provides a clear understanding of the maximum amount they will need to pay for healthcare services.Rate this question:
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- 8.
Does RMHP cover an annual routine physical exam?
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
RMHP does cover an annual routine physical exam. This means that individuals with RMHP insurance can receive coverage for their regular check-ups and preventive screenings, allowing them to maintain their overall health and detect any potential health issues early on. This coverage encourages individuals to prioritize their well-being and take proactive measures to prevent and manage any health conditions.Rate this question:
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- 9.
Does a deductible apply to preventive care?
- A.
Yes
- B.
No
Correct Answer
B. NoExplanation
A deductible is an amount that the insured person must pay before the insurance company starts covering the costs. In the case of preventive care, such as regular check-ups, vaccinations, and screenings, insurance plans often do not require a deductible. This means that individuals can receive preventive care without having to pay any out-of-pocket expenses before the insurance coverage kicks in. Therefore, the correct answer is "no."Rate this question:
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- 10.
RMHP has a preferred pharmacy network.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
RMHP stands for Rocky Mountain Health Plans, which is a health insurance provider. The statement "RMHP has a preferred pharmacy network" means that RMHP has a network of pharmacies that it prefers its policyholders to use for their medication needs. This could mean that policyholders may receive additional benefits or discounts when using pharmacies within this network. Therefore, the correct answer is true.Rate this question:
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- 11.
Rocky Mountain Green Plan Benefit Copays: Ambulance Services
- A.
$300
- B.
$350
- C.
$200
Correct Answer
C. $200Explanation
The correct answer is $200. This indicates that the copay for ambulance services under the Rocky Mountain Green Plan is $200.Rate this question:
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- 12.
Rocky Mountain Green Plan Benefit Copays: Inpatient Hospital Care Per day
- A.
$200
- B.
$300
- C.
$350
Correct Answer
C. $350Explanation
The correct answer is $350 because it is the highest amount listed for the copay for inpatient hospital care per day. This means that if someone is enrolled in the Rocky Mountain Green Plan and requires inpatient hospital care, they would need to pay $350 per day for that care.Rate this question:
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- 13.
Rocky Mountain Green Plan Benefit Copays: Level I Tier 3 Drug
- A.
$50
- B.
$40
- C.
$20
Correct Answer
B. $40Explanation
The given answer of $40 is the copay amount for a Level I Tier 3 drug under the Rocky Mountain Green Plan Benefit. This means that for any prescription medication classified as a Level I Tier 3 drug, the plan member will be required to pay $40 out of pocket as their copay.Rate this question:
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- 14.
Rocky Mountain Green Plan Benefit Copays: PCP Visit
- A.
$25
- B.
$30
- C.
$55
Correct Answer
A. $25Explanation
The given correct answer is $25. This implies that for a PCP visit under the Rocky Mountain Green Plan, the copay amount is $25. This means that the plan holder will have to pay this fixed amount out of pocket for each primary care physician visit, regardless of the total cost of the visit.Rate this question:
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- 15.
Rocky Mountain Green Plan Benefit Copays: Specialist Visit
- A.
$25
- B.
$40
- C.
$55
Correct Answer
C. $55Explanation
The given answer of $55 is the correct copay for a specialist visit under the Rocky Mountain Green Plan Benefit. This means that if a member of the plan visits a specialist, they will be required to pay $55 out of pocket for the visit.Rate this question:
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- 16.
Rocky Mountain Green Plan Benefit Copays: Urgent Care
- A.
$60
- B.
$50
- C.
$55
Correct Answer
C. $55Explanation
The correct answer is $55 because it is the cost of the copay for urgent care services under the Rocky Mountain Green Plan Benefit. The other options, $60 and $50, are not the correct copay amounts for urgent care services.Rate this question:
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- 17.
Rocky Mountain Thrifty Plan: Emergency Care Covered Worldwide
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
The Rocky Mountain Thrifty Plan provides coverage for emergency care worldwide. This means that if an individual with this plan experiences a medical emergency while traveling outside of their home country, their emergency care expenses will be covered. This is beneficial for individuals who frequently travel or for those who want the security of knowing they will be protected in case of an emergency while abroad.Rate this question:
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- 18.
Rocky Mountain Thrifty Plan: Inpatient Hospital Care Per day
- A.
$200
- B.
$300
- C.
$250
Correct Answer
C. $250Explanation
The correct answer is $250 because it is the cost for inpatient hospital care per day under the Rocky Mountain Thrifty Plan. The other options, $200 and $300, are not the correct answers as they do not match the given information.Rate this question:
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- 19.
Rocky Mountain Thrifty Plan: Annual Deductible
- A.
$450
- B.
$350
- C.
$500
Correct Answer
A. $450Explanation
The correct answer is $450. This is the annual deductible amount for the Rocky Mountain Thrifty Plan. Deductible is the amount that the insured person must pay out of pocket before the insurance company starts covering the costs. In this case, the insured person would need to pay $450 before the insurance coverage kicks in.Rate this question:
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- 20.
Rocky Mountain Standard Plan: Ambulance Services
- A.
$300
- B.
$350
- C.
$200
Correct Answer
C. $200Explanation
The correct answer is $200. This is the cost of the ambulance services under the Rocky Mountain Standard Plan.Rate this question:
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- 21.
Rocky Mountain Standard Plan: Emergency Care
- A.
$65
- B.
$55
- C.
$45
Correct Answer
A. $65Explanation
The given correct answer is $65. This implies that the cost of emergency care under the Rocky Mountain Standard Plan is $65.Rate this question:
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- 22.
Rocky Mountain Standard Plan: X-rays
- A.
$20
- B.
$30
- C.
$0
Correct Answer
A. $20Explanation
The given correct answer is $20. This suggests that under the Rocky Mountain Standard Plan, the cost for X-rays is $20.Rate this question:
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- 23.
Rocky Mountain Plus Plan: MRI/PET
- A.
$150
- B.
$100
- C.
$200
Correct Answer
A. $150Explanation
The given answer of $150 is the cost of the Rocky Mountain Plus Plan for an MRI/PET scan.Rate this question:
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- 24.
Rocky Mountain Plus Plan: Outpatient Surgery
- A.
$350
- B.
$300
- C.
$400
Correct Answer
B. $300Explanation
The given answer is $300 because it is the cost of the outpatient surgery under the Rocky Mountain Plus Plan. The plan offers three different prices for outpatient surgery, $350, $300, and $400. Since the answer is $300, it means that the cost of the surgery falls under the middle price option.Rate this question:
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- 25.
Rocky Mountain Plus Plan: Annual Deductible
- A.
$0
- B.
$450
- C.
$200
Correct Answer
A. $0Explanation
The given correct answer is $0. This means that under the Rocky Mountain Plus Plan, there is no annual deductible. This implies that the plan does not require the insured individual to pay any out-of-pocket costs before the insurance coverage kicks in. This can be advantageous for policyholders as it reduces their financial burden and allows them to receive medical services without having to meet a deductible first.Rate this question:
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- 26.
Plus Plan Level 1 Tier 4 Drug Copay:
- A.
$25
- B.
$45
- C.
$60
Correct Answer
C. $60Explanation
The correct answer is $60. This indicates that for the Plus Plan Level 1 Tier 4 drugs, the copay amount is $60. This means that individuals who are on this plan will have to pay $60 out of pocket for each prescription of Tier 4 drugs.Rate this question:
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- 27.
Optional Supplemental Delta Dental Premiums:
- A.
$12/month
- B.
$18/month
- C.
$15/month
Correct Answer
B. $18/monthExplanation
The correct answer is $18/month because it is the highest premium option among the given choices. This suggests that it offers more comprehensive coverage or additional benefits compared to the other options with lower premiums.Rate this question:
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- 28.
Optional Supplemental Delta Dental Maximum Benefit per Calendar Year:
- A.
$1,200
- B.
$2,000
- C.
$1,500
Correct Answer
C. $1,500Explanation
The correct answer is $1,500. This is the maximum benefit per calendar year that Delta Dental provides for optional supplemental coverage. It means that the policyholder can receive up to $1,500 worth of dental services and treatments within a single calendar year.Rate this question:
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- 29.
Optional Supplemental VSP Vision Premiums:
- A.
$12/month
- B.
$18/month
- C.
$15/month
Correct Answer
A. $12/monthExplanation
The optional supplemental VSP vision premium is $12 per month.Rate this question:
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- 30.
Value Added Service products are available on ALL plans with no additional cost to RMHP members.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Value Added Service products are available on ALL plans with no additional cost to RMHP members. This means that regardless of the plan they have chosen, RMHP members can access Value Added Service products without any extra charges. This suggests that RMHP is committed to providing additional benefits and services to its members, enhancing their overall healthcare experience.Rate this question:
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- 31.
Durable Medical Equipment is 20% Co-insurance after the plan’s deductible?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because it states that Durable Medical Equipment requires a 20% co-insurance payment after the deductible has been met. This means that once the deductible has been paid, the individual is responsible for paying 20% of the cost of the durable medical equipment, while the insurance plan covers the remaining 80%.Rate this question:
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- 32.
Members do not need Referrals to use specialists on all RMHP Cost plans?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Members on RMHP Cost plans do not need referrals to use specialists. This means that they have the freedom to directly access specialist care without having to obtain a referral from their primary care physician. This allows for more flexibility and convenience in seeking specialized medical treatment.Rate this question:
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- 33.
Members can utilize original Medicare benefits for out-of-network, non-emergency care anywhere in the United States and would be responsible for the Part A+ B deductible and co-insurance.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Members who are enrolled in original Medicare can indeed utilize their benefits for out-of-network, non-emergency care anywhere in the United States. However, they would still be responsible for paying the Part A and Part B deductibles, as well as any applicable co-insurance for the services received. This means that while they have the flexibility to receive care from providers who are not in their network, they will still have to cover certain costs out of pocket.Rate this question:
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- 34.
Can Members who want Part D, purchase a stand-alone Part D plan from another carrier?
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
Members who want Part D can purchase a stand-alone Part D plan from another carrier. This means that individuals who are seeking prescription drug coverage can choose to buy a separate Part D plan from a different insurance provider instead of obtaining it through their current carrier. This gives them the flexibility to select a plan that best suits their needs and preferences.Rate this question:
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- 35.
Does RMHP offer a cost plan for “Part B only” members?
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
RMHP does offer a cost plan for "Part B only" members.Rate this question:
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- 36.
Who is the Mail Order Pharmacy provider?
Correct Answer
Welldyne
Welldyne Rx West
Welldyne Rx
Welldyne WestExplanation
The Mail Order Pharmacy provider is Welldyne. Welldyne Rx West, Welldyne Rx, and Welldyne West are all variations or subsidiaries of Welldyne, indicating that they are also part of the Mail Order Pharmacy service provided by Welldyne.Rate this question:
- 37.
Medicaid prospects would be best served by which plan?
- A.
Plus w/D
- B.
Std. Medical only
- C.
AB BASIC
- D.
Part D only
Correct Answer
C. AB BASICExplanation
AB BASIC would be the best plan for Medicaid prospects. This plan provides comprehensive coverage, including both medical and prescription drug benefits. It offers a wider range of services compared to the other options listed, such as Plus w/D and Std. Medical only, which may have limited coverage or exclude certain services. Additionally, AB BASIC ensures that Medicaid prospects have access to necessary medications through its Part D coverage.Rate this question:
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- 38.
Provider copays are billed by RMHP for what areas?
- A.
METRO
- B.
FRONT RANGE
- C.
Statewide
- D.
Most West Slope counties
Correct Answer
D. Most West Slope countiesExplanation
The correct answer is Most West Slope counties. This means that RMHP bills provider copays for services in the majority of the counties located in the West Slope region.Rate this question:
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- 39.
Does Copay collection include Part D copays?
- A.
Yes
- B.
No
Correct Answer
B. NoExplanation
The answer is "no" because Copay collection does not include Part D copays. Copay collection refers to the amount of money that a patient pays out-of-pocket for a specific medical service or prescription drug. Part D copays, on the other hand, are specific to Medicare Part D prescription drug plans and are separate from regular copay collections. Therefore, Part D copays are not included in the general copay collection.Rate this question:
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- 40.
Is there a Hearing Discount benefit for cost plan members?
- A.
Yes
- B.
No
Correct Answer
A. YesExplanation
The given correct answer is "yes" because cost plan members are eligible for a Hearing Discount benefit. This means that they can avail discounts on hearing-related services and products, such as hearing aids and exams. This benefit helps cost plan members save money on their hearing healthcare expenses.Rate this question:
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Mar 20, 2023Quiz Edited by
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