2014 - Qm - Medigap Benefits

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About This Quiz

This quiz assesses knowledge on Medigap benefits, specifically focusing on Plan N, Plan K, Plan F, and High Deductible Plan F. It evaluates understanding of required disclosures, deductible... see moredetails, and the absence of network restrictions in Medigap plans, crucial for compliance and accurate customer service. see less

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

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.”

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.

Part B Excess

All of the Above

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

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.

Explanation

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

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

#14-Doctor and Hospital Choice

#15-Deductible for Medical Only

#18-Doctor Office Visit

#15-You must pay the first $2,140 (for 2014) in Medicare-covered costs before the Medigap plan pays anything.

Explanation

#15-You must pay the first $2,140 (for 2014) in Medicare-covered costs before the Medigap plan pays anything.

4. 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?

15, 18 and 20

15, 16, 18 and 20

15, 16, 17, 18 and 20

None of the above

The ADP/BA is not required to read any benefits when completing the application for the Plan K.

Explanation

The ADP/BA is not required to read any benefits when completing the application for the Plan K.

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

True

False

ADP's or BA's are also not required to read any benefits for the Plan F

Explanation

ADP's or BA's are also not required to read any benefits for the Plan F

6. 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?

Non-Baseline benefits

Coach

Red Flag

This is accurate, so the form should not be marked

(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.

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.

7. 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.

True

False

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

Explanation

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

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

True

False

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.

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.

9. 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?

Yes

Minor

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

Explanation

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

10. Match the line item number to the required benefit(s) to the plan type that must be stated during the benefit portion of the application.

Plan F

Plan N

High Deductible Plan F

Select

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Current Version
Mar 21, 2023

Quiz Edited by
ProProfs Editorial Team
Jul 17, 2014

Quiz Created by
Bthorup