2015 The Health Plan Test
- 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
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