2014 - Qm - Medigap Benefits

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2014 - Qm - Medigap Benefits - Quiz

Questions and Answers
  • 1. 

    ADP/BA is completing a Medigap Plan N. What benefits are they required to read?

    • A.

      Doctor and Hospital Choice-“You can go to any doctor, supplier, hospital, or other facility that is enrolled in Medicare and is accepting new Medicare patients.”

    • B.

      Medical Expenses-Covers 100% of Part B coinsurance after you meet your yearly Part B deductible ($147.00 for 2014). You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits.

    • C.

      Part B Excess

    • D.

      All of the Above

    • E.

      None of the Above-Benefits are not required to be read on any Medigap plans

    Correct Answer
    B. Medical Expenses-Covers 100% of Part B coinsurance after you meet your yearly Part B deductible ($147.00 for 2014). You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits.
    Explanation
    It is acceptable to stated Covers 100% of Part B coinsurance after you meet your yearly Part B deductible. You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits.

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  • 2. 

    BA is completing a Medigap Plan N application.    The benefits in the SSC read:Covers 100% of Part B coinsurance after you meet your yearly Part B deductible ($147.00 for 2014). You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits. The BA did not inform what the Part B deductible was and only stated “Covers 100% of Part B coinsurance after you meet your yearly Part B deductible. You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits. How should line item 15 be scored? 

    • A.

      Yes

    • B.

      Minor

    • C.

      NA

    Correct Answer
    A. Yes
    Explanation
    Yes-As long as the BA informed that the Customer would have to meet the Part B deductible, the amount is not required.

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  • 3. 

    Which line items would be required to mark and a minor if the ADP did not read any of the benefits for the Plan K?

    • A.

      15, 18 and 20

    • B.

      15, 16, 18 and 20

    • C.

      15, 16, 17, 18 and 20

    • D.

      None of the above

    Correct Answer
    D. None of the above
    Explanation
    The ADP/BA is not required to read any benefits when completing the application for the Plan K.

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  • 4. 

    When completing the application for the Medigap Plan F, the ADP/BA stated “The plan F covers you 100%.” This should be marked down because they did not inform the Customer that it covers 100% on Medicare covered services.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    False-They are trained that the Plan F covers 100% and should not be marked down.

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  • 5. 

    Customer is enrolling into a High Deductible Plan F. Which benefits are required to be read to the Customer?

    • A.

      None, the benefits are not required for the Plan F.

    • B.

      #14-Doctor and Hospital Choice

    • C.

      #15-Deductible for Medical Only

    • D.

      #18-Doctor Office Visit

    Correct Answer
    C. #15-Deductible for Medical Only
    Explanation
    #15-You must pay the first $2,140 (for 2014) in Medicare-covered costs before the Medigap plan pays anything.

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  • 6. 

    A Customer does not need to worry about any networks if they choose a Medigap plan, unlike a HMO or PPO plan.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    False-Medicare Select is a type of Medigap policy that requires you the use of hospitals and, in some cases, doctors within the network to be eligible for full insurance benefits.

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  • 7. 

    Medigap Plan N:Covers 100% of Part B coinsurance after you meet your yearly Part ____ deductible ($147.00 for 2014). You have to pay an additional copayment of up to $20 for some office visits and up to $50 for ER visits.

    Correct Answer
    B
    b
  • 8. 

    A  Kentucky couple are both enrolling into an AARP Medicare Supplement Plan from United Healthcare Plan F. The ADP informs the Customers that they will get the spouse discount which means they can take 5% off your monthly premiums if two members are on the same AARP account and each is insured under an AARP supplemental insurance policy with UnitedHealthcare.  How should you mark the form?

    • A.

      Non-Baseline benefits

    • B.

      Coach

    • C.

      Red Flag

    • D.

      This is accurate, so the form should not be marked

    Correct Answer
    A. Non-Baseline benefits
    Explanation
    (Not available in CO, FL, KY, MI, MT, NJ, NY, and SD) If the ADP/BA reads a non-required benefit, it must be read accurately.

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  • 9. 

    The BA skipped the benefits completely when the Customer was enrolling into a Medigap Plan F. This is acceptable for only a BA.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    ADP's or BA's are also not required to read any benefits for the Plan F

    Rate this question:

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jul 17, 2014
    Quiz Created by
    Bthorup
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