2015 The Health Plan Test

40 Questions | Total Attempts: 1057

SettingsSettingsSettings
Please wait...
2015 The Health Plan Test

Questions and Answers
  • 1. 
    In 2015, The Health Plan/THP will continue to offer SecureChoice PPO and SecureAdvantage RX PDP plans in all regions: HomeTown, Ohio Valley and Mountaineer.
    • A. 

      True

    • B. 

      False

  • 2. 
    Which of the following is true?
    • A. 

      There are Medicare Supplement Plans that require the insured to pay copays.

    • B. 

      THP Medicare Supplement plans are standardized policies. The only difference between us and other insurance carriers is what plans are offered and the monthly premiums.

    • C. 

      There are Medicare Supplement plans that require the insured to pay the Part A and/or Part B deductible.

    • D. 

      All of the above

  • 3. 
    All Medicare Advantage plan enrollees have to reside in the service area designated for their selected plan.
    • A. 

      True

    • B. 

      False

  • 4. 
    In 2015, the Ohio Valley, Mountaineer and HomeTown regions will all offer the SecureCare POS plan.
    • A. 

      True

    • B. 

      False

  • 5. 
    The out-of-pocket maximum is the amount a member will pay in copays/coinsurance (excluding any plan premiums) before medical benefits are covered at 100% for the remainder of the calendar year.
    • A. 

      True

    • B. 

      False

  • 6. 
    The 2015 annual out-of pocket maximum for a SecureCareHMO plan member could be (depending on the plan they choose) :
    • A. 

      $3,600

    • B. 

      $10,000

    • C. 

      $6,700

    • D. 

      A and C

  • 7. 
    In 2015, the Medicare plans available in the HomeTown Region are:
    • A. 

      SecureCareHMO Opt I, II, III and IV, SecureCare POS and SecureAdvantageRX PDP

    • B. 

      SecureCareHMO Options I, II, IV and SecureChoicePPO Options I and II

    • C. 

      SecureCareHMO Option I, II and IV and Medicare Supplement plans

    • D. 

      All of same plans offered in 2014

  • 8. 
    In 2015, The Ohio Valley and Mountaineer Regions have been split into 2 segments. Segments are determined by:
    • A. 

      Zip code

    • B. 

      City

    • C. 

      County

  • 9. 
    What is the Skilled Nursing Facility copay on all Health Plan Medicare Advantage plans for days 1-20?
    • A. 

      $37.50

    • B. 

      $50

    • C. 

      $0

  • 10. 
    The Ohio Valley and Mountaineer regions have been split into 2 segments. Which of the following regarding Segment 1(S1) vs. Segment 2 (S2) is true?
    • A. 

      SecureCareHMO and SecureChoice PPO benefits and premiums are different depending on the segment.

    • B. 

      SecureCareHMO and SecureChoicePPO plan benefits are the same in Segment 1(S1) and Segment (S2); the premiums are different.

  • 11. 
    What plan(s) have been eliminated in the HomeTown region.
    • A. 

      SecureChoicePPO

    • B. 

      SecureAdvantageRX PDP

    • C. 

      Both SecureChoicePPO and SecureAdvantageRX PDP

  • 12. 
    Which of the following is true?
    • A. 

      SecureChoicePPO is a regional Medicare Advantage PPO offered in Ohio, West Virginia and Pennsylvania

    • B. 

      SecureChoicePPO is a local Medicare Advantage PPO offered in the Ohio Valley, Mountaineer and HomeTown regions

    • C. 

      SecureChoicePPO is a local Medicare Advantage PPO offered in the Ohio Valley and Mountaineer regions.

  • 13. 
    What is the Primary Care Physician (PCP) copay under the SecureCareHMO Opt IV plan in the HomeTown region (H3672-018)?
    • A. 

      $15

    • B. 

      $0

    • C. 

      $35

  • 14. 
    Which of our plans requires the use of a provider network?
    • A. 

      SecureChoice PPO

    • B. 

      Medicare Supplement plans

    • C. 

      Both a and b

    • D. 

      Neither a and b

  • 15. 
    Which Medicare Supplement plans are available in 2015?
    • A. 

      Plans A, C, D, F, G and N

    • B. 

      Plans, A, C, D F, High Deductible F, G and N

    • C. 

      Plans A, C, D, F, and High Deductible Plan F

  • 16. 
    Which plan(s) offer the Silver Sneakers Fitness program to their plan members?
    • A. 

      All regions’ SecureCareHMO and SecureChoice PPO plans

    • B. 

      Only HomeTown region SecureCareHMO plans

    • C. 

      HomeTown region SecureCareHMO plans and all Medicare Supplement plans

  • 17. 
    To enroll in a THP Medicare Supplement plan, which of the following is true?
    • A. 

      The applicant must be age 65 and enrolled in Medicare A and B

    • B. 

      The applicant can be any age and enrolled in Medicare A and B

  • 18. 
    The annual out of pocket maximum for the SecureChoicePPO plans is:
    • A. 

      $6,700 in-network/ $10,000 out-of-network

    • B. 

      $3,400 in-network/$6,700 in and out-of-network combined

    • C. 

      $6,700 in-network/ $10,000 in and out-of-network combined

  • 19. 
    Unlike labwork and x-rays, the diagnostic radiology (MRI, CT, MRA, PET and SPECT) copay DOES APPY if performed in a plan physician’s office.
    • A. 

      True

    • B. 

      False

  • 20. 
    THP Medicare Supplement plans are offered in which states?
    • A. 

      Ohio, West Virginia and Pennsylvania

    • B. 

      Pennsylvania and Ohio

    • C. 

      Ohio and West Virginia

  • 21. 
    In which situation would a member pay 20% for preventive services?
    • A. 

      SecureChoicePPO out-of-network preventive services

    • B. 

      SecureCare POS plan

    • C. 

      HomeTown Region SecureCareHMO Option IV

  • 22. 
    Preferred diabetic supplies have a $7.50 co-payment for a one month supply, up to which quantity without prior authorization?
    • A. 

      10

    • B. 

      50

    • C. 

      100

    • D. 

      200

  • 23. 
    SecureCareHMO members can get their non-Medicare covered eyeglasses at any provider and still get the plan benefits.
    • A. 

      True

    • B. 

      False

  • 24. 
    Which of the following is correct?
    • A. 

      In 2015 there are 5 tiers of prescription drug copays: Tier 1- Preferred Generic, Tier 2–Non Preferred Generic, Tier 3 - Preferred Brand, Tier 4 –Non Preferred Brand and Tier 5–Specialty drugs

    • B. 

      In 2015 there are 4 tiers of prescription drug copays: Tier 1- Preferred Generic, Tier 2- Non Preferred Generic, Tier 3- Preferred Brand and Tier 4–Specialty drugs

  • 25. 
    What is the SecureCareHMO and SecureChoicePPO plan coverage limit for the VSP routine eyewear benefit?
    • A. 

      $150

    • B. 

      20% discount on eyewear - unlimited

    • C. 

      $100 every two years

    • D. 

      $250

Related Topics
Back to Top Back to top