2015 Bcbs Of Ri

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  • 1/30 Questions

    All of the following services apply towards Out‐of‐Pocket Maximum in 2015 except:a) Hospital Copayment.b) Physician Office Visit copayment.c) Part D Prescription Copayment.d) Skilled Nursing Copayment .e) Dental

    • Both A & E
    • Both B & C
    • B,D & E
    • Both C& E
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2015 Bcbs Of Ri - Quiz

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  • 2. 

    What is the copayment for diabetic monitoring supplies on all plans in 2015?

    • $40

    • 20%

    • $15

    • 15%

    • $0

    Correct Answer
    A. $0
    Explanation
    In 2015, the copayment for diabetic monitoring supplies on all plans was $0. This means that individuals with diabetes did not have to pay any out-of-pocket cost for their monitoring supplies, such as glucose meters, test strips, and lancets. This was likely done to ensure that individuals with diabetes have access to the necessary tools for managing their condition without facing financial barriers.

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  • 3. 

    Anyone can sell the BlueCHiP for Medicare Select plan to new clients in 2015?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Not anyone can sell the BlueCHiP for Medicare Select plan to new clients in 2015. Only authorized agents or brokers who are licensed and appointed by BlueCHiP can sell this plan to new clients.

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  • 4. 

    Which plan(s) below have a $0 monthly premium?A. ValueB. CoreC. PlusD. Select

    • Both A & D

    • Both B & C

    • A Only

    • A, B & D

    Correct Answer
    A. A, B & D
    Explanation
    The plans that have a $0 monthly premium are A, B, and D. This means that individuals who choose these plans will not have to pay any monthly fees.

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  • 5. 

    The copayment for Lab for BlueChip for Medicare Value, Core, Select & Standard with Drugs is $10 perday?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The statement is false because the copayment for Lab for BlueChip for Medicare Value, Core, Select & Standard with Drugs is not $10 per day. The question does not provide any information about the actual copayment amount, so it cannot be determined from the given information.

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  • 6. 

    An individual is eligible for BCBSRI’s Medicare plans if they?

    • Have Medicare Part A and Part B and continue to pay premiums for A and B where applicable.

    • Live in Rhode Island.

    • Have had a successful kidney transplant if they have ESRD.

    • All of the above.

    Correct Answer
    A. All of the above.
    Explanation
    The correct answer is "All of the above" because eligibility for BCBSRI's Medicare plans requires having Medicare Part A and Part B and continuing to pay premiums for A and B where applicable, living in Rhode Island, and having had a successful kidney transplant if the individual has ESRD.

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  • 7. 

    Which of the following is NOT a benefit of the Value Plan?

    • Dental

    • Vision Hardware.

    • Skilled Nursing Facility.

    • Routine Vision Exam

    Correct Answer
    A. Vision Hardware.
    Explanation
    The Value Plan offers several benefits, including dental coverage, skilled nursing facility coverage, and routine vision exams. However, it does not provide coverage for vision hardware such as glasses or contact lenses. Therefore, Vision Hardware is not a benefit of the Value Plan.

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  • 8. 

    What is the Outpatient surgery copayment for the Extra plan?

    • $125

    • $150

    • $175

    • $200

    Correct Answer
    A. $175
    Explanation
    The correct answer for the Outpatient surgery copayment for the Extra plan is $175. This means that for each outpatient surgery, the plan holder will need to pay a copayment of $175.

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  • 9. 

    What is the Vision hardware allowance for the Extra plan?

    • $100

    • $125

    • $150

    • There isn’t any

    Correct Answer
    A. $125
    Explanation
    The Vision hardware allowance for the Extra plan is $125.

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  • 10. 

    Which of the following demonstrates the correct copayment amounts for the Select Plan?

    • Hospital $285/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $150; Days 46‐100 $0

    • Hospital $345/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $155; Days 46‐100 $0

    • Hospital $500 per admission; SNF 1‐20 days $30; Days 21‐35 $150; Days 36‐100 $0

    • Hospital $750 per admission; SNF 1‐20 days $30; Days 21‐35 $150; Days 36‐100 $0

    • None of the above.

    Correct Answer
    A. Hospital $285/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $150; Days 46‐100 $0
    Explanation
    The correct answer demonstrates the correct copayment amounts for the Select Plan. For hospital stays, the copayment is $285 per day for the first 1-5 days. For skilled nursing facility (SNF) stays, there is no copayment for the first 1-20 days. From days 21-45, the copayment is $150 per day. From days 46-100, there is no copayment. This is the only option that matches these copayment amounts.

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  • 11. 

    What is cost sharing for prescription drugs on the Value plan?

    • $4/$45/$95/33%

    • $0/$45/$95/30% $100 Brand Deductible

    • $2/$45/$95/30% $320 Brand Deductible

    • $6/$20/$50/25%

    Correct Answer
    A. $2/$45/$95/30% $320 Brand Deductible
  • 12. 

    What is the cost sharing for prescription drugs on the Select plan?

    • $0/$24/$52/25% $320 brand deductible

    • $3/$10/$45/$95/33%

    • $0/$45/$95/28% $200 brand deductible

    • $20/$60/$130/25%

    Correct Answer
    A. $0/$45/$95/28% $200 brand deductible
    Explanation
    The cost sharing for prescription drugs on the Select plan is $0 for generic drugs, $45 for preferred brand drugs, $95 for non-preferred brand drugs, and 28% for specialty drugs. There is also a $200 brand deductible.

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  • 13. 

    All BlueCHiP for Medicare options offer vision hardware.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The statement is false because not all BlueCHiP for Medicare options offer vision hardware. Some options may include vision hardware benefits, while others may not. Therefore, it cannot be said that all options offer vision hardware.

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  • 14. 

    A member who utilizes the Living Fit benefit pays a $5 copayment per month and can enroll in multiplehealth clubs at a time?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The statement says that a member who utilizes the Living Fit benefit pays a $5 copayment per month and can enroll in multiple health clubs at a time. However, the correct answer is False because it contradicts the statement. If the member can enroll in multiple health clubs at a time, it means they can join more than one club simultaneously, but the statement says they can only enroll in one club and pay a $5 copayment per month. Therefore, the answer is False.

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  • 15. 

    What is the Maximum Out‐of‐Pocket (MOOP) for the Value plan?

    • $4,950

    • $4,450

    • $4,250

    • $5,000

    Correct Answer
    A. $5,000
    Explanation
    The Maximum Out-of-Pocket (MOOP) for the Value plan is $5,000. This means that once an individual or family reaches this amount in medical expenses, the insurance plan will cover 100% of any additional costs for the rest of the coverage period.

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  • 16. 

    There is a $65 copayment for Emergency Visits for all BlueCHiP for Medicare Advantage plans?

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The given statement is true. BlueCHiP for Medicare Advantage plans require a $65 copayment for Emergency Visits. This means that if a person with this plan needs to visit the emergency room, they will be responsible for paying a copayment of $65.

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  • 17. 

    Blue Cross Blue Shield of Rhode Island pharmacy Benefit Manager is Catamaran?

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Blue Cross Blue Shield of Rhode Island pharmacy Benefit Manager is Catamaran. This statement is true. Catamaran is a pharmacy benefit management company that provides services to various health insurance organizations, including Blue Cross Blue Shield of Rhode Island. As a pharmacy benefit manager, Catamaran helps to manage and administer prescription drug benefits for Blue Cross Blue Shield of Rhode Island members.

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  • 18. 

    In the Select Network, a member will not be able to see any Specialist of their choice?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    In the Select Network, a member will be able to see any Specialist of their choice. This means that they have the freedom to choose from a variety of specialists based on their preferences and needs.

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  • 19. 

    How many Skilled Nursing Facilities are part of the Select Network?

    • 77

    • 7

    • 11

    • 80

    Correct Answer
    A. 11
  • 20. 

    Which hospital is not included in the Select Network?

    • South County

    • Memorial

    • Landmark

    • Miriam

    Correct Answer
    A. Miriam
    Explanation
    Miriam hospital is not included in the Select Network.

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  • 21. 

    Which Primary Care Physician Groups are part of the Select Network?a) University Medicine Groupb) Rhode Island Primary Physicians Corp.c) Coastal Medical Groupd) Care New Englande) Orthopedic Group of RI

    • A, B, C

    • B and D

    • B and E

    • B, C, and D

    Correct Answer
    A. B and D
    Explanation
    The correct answer is B and D. This means that the Primary Care Physician Groups that are part of the Select Network are Rhode Island Primary Physicians Corp. and Care New England.

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  • 22. 

    Does the Select plan have a Point‐of‐Service (POS) benefit?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The Select plan does not have a Point-of-Service (POS) benefit.

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  • 23. 

    What is the inpatient hospital stay for days 1‐5 for the Extra plan?

    • $190

    • $285

    • $350

    • $275

    Correct Answer
    A. $275
    Explanation
    The inpatient hospital stay for days 1-5 for the Extra plan is $275.

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  • 24. 

    What is the prescription drug deductible for the Extra plan?

    • $200

    • $320

    • $100

    • None

    Correct Answer
    A. None
    Explanation
    The prescription drug deductible for the Extra plan is None. This means that there is no deductible amount that needs to be paid before the plan starts covering the cost of prescription drugs.

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  • 25. 

    Are hearing aids covered on the Extra plan?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Hearing aids are not covered on the Extra plan.

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  • 26. 

    What is the outpatient surgery cost‐sharing for the Value plan?

    • $150

    • $175

    • 20%

    • 35%

    Correct Answer
    A. 20%
    Explanation
    The outpatient surgery cost-sharing for the Value plan is 20%. This means that the plan will cover 80% of the cost of the surgery, while the individual will be responsible for paying the remaining 20%.

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  • 27. 

    What is the inpatient hospital stay for days 1‐5 for the Select plan?

    • $275

    • $345

    • $180

    • $285

    Correct Answer
    A. $285
    Explanation
    The inpatient hospital stay for days 1-5 for the Select plan is $285.

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  • 28. 

    What is the Maximum Out‐of‐Pocket (MOOP) for the Extra?

    • $5,000

    • $2,800

    • $4,250

    • $3,750

    Correct Answer
    A. $3,750
    Explanation
    The Maximum Out-of-Pocket (MOOP) for the Extra is $3,750. This means that once an individual has spent $3,750 on covered medical expenses, their insurance plan will cover 100% of any additional costs for the rest of the year.

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  • 29. 

    Which plan has prescription drug coverage through the Gap?

    • Extra

    • Preferred

    • Plus

    • Select

    Correct Answer
    A. Preferred
    Explanation
    Preferred plan has prescription drug coverage through the Gap.

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  • 30. 

    If a member sees a primary care physician outside of the Select network, they would pay a $0 copayment.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    If a member sees a primary care physician outside of the Select network, they would not pay a $0 copayment. This means that there would be some form of payment required if they choose to see a primary care physician outside of the network.

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  • Current Version
  • Jul 22, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 23, 2014
    Quiz Created by
    Bthorup
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