2014 - Qm - Medigap Benefits

10 Questions | Total Attempts: 179

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2014 - Qm - Medigap Benefits

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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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.
  • 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

  • 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

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