2015 Bcbs Of Ri
Questions and Answers
- 1.
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
- A.
Both A & E
- B.
Both B & C
- C.
B,D & E
- D.
Both C& E
Correct Answer
D. Both C& EExplanation
The correct answer is Both C& E. In 2015, all of the following services apply towards the Out-of-Pocket Maximum except for Part D Prescription Copayment and Dental services. This means that the costs associated with hospital copayments, physician office visit copayments, and skilled nursing copayments will contribute towards reaching the Out-of-Pocket Maximum, but the costs for Part D Prescription Copayments and Dental services will not.Rate this question:
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- 2.
What is the copayment for diabetic monitoring supplies on all plans in 2015?
- A.
$40
- B.
20%
- C.
$15
- D.
15%
- E.
$0
Correct Answer
E. $0Explanation
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.Rate this question:
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- 3.
Anyone can sell the BlueCHiP for Medicare Select plan to new clients in 2015?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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- 4.
Which plan(s) below have a $0 monthly premium?A. ValueB. CoreC. PlusD. Select
- A.
Both A & D
- B.
Both B & C
- C.
A Only
- D.
A, B & D
Correct Answer
D. A, B & DExplanation
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.Rate this question:
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- 5.
The copayment for Lab for BlueChip for Medicare Value, Core, Select & Standard with Drugs is $10 perday?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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- 6.
An individual is eligible for BCBSRI’s Medicare plans if they?
- A.
Have Medicare Part A and Part B and continue to pay premiums for A and B where applicable.
- B.
Live in Rhode Island.
- C.
Have had a successful kidney transplant if they have ESRD.
- D.
All of the above.
Correct Answer
D. 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.Rate this question:
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- 7.
Which of the following is NOT a benefit of the Value Plan?
- A.
Dental
- B.
Vision Hardware.
- C.
Skilled Nursing Facility.
- D.
Routine Vision Exam
Correct Answer
B. 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.Rate this question:
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- 8.
What is the Outpatient surgery copayment for the Extra plan?
- A.
$125
- B.
$150
- C.
$175
- D.
$200
Correct Answer
C. $175Explanation
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.Rate this question:
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- 9.
What is the Vision hardware allowance for the Extra plan?
- A.
$100
- B.
$125
- C.
$150
- D.
There isn’t any
Correct Answer
B. $125Explanation
The Vision hardware allowance for the Extra plan is $125.Rate this question:
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- 10.
Which of the following demonstrates the correct copayment amounts for the Select Plan?
- A.
Hospital $285/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $150; Days 46‐100 $0
- B.
Hospital $345/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $155; Days 46‐100 $0
- C.
Hospital $500 per admission; SNF 1‐20 days $30; Days 21‐35 $150; Days 36‐100 $0
- D.
Hospital $750 per admission; SNF 1‐20 days $30; Days 21‐35 $150; Days 36‐100 $0
- E.
None of the above.
Correct Answer
A. Hospital $285/day 1‐5; SNF 1‐20 days $0; Days 21‐45 $150; Days 46‐100 $0Explanation
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.Rate this question:
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- 11.
What is cost sharing for prescription drugs on the Value plan?
- A.
$4/$45/$95/33%
- B.
$0/$45/$95/30% $100 Brand Deductible
- C.
$2/$45/$95/30% $320 Brand Deductible
- D.
$6/$20/$50/25%
Correct Answer
C. $2/$45/$95/30% $320 Brand Deductible -
- 12.
What is the cost sharing for prescription drugs on the Select plan?
- A.
$0/$24/$52/25% $320 brand deductible
- B.
$3/$10/$45/$95/33%
- C.
$0/$45/$95/28% $200 brand deductible
- D.
$20/$60/$130/25%
Correct Answer
C. $0/$45/$95/28% $200 brand deductibleExplanation
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.Rate this question:
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- 13.
All BlueCHiP for Medicare options offer vision hardware.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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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?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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- 15.
What is the Maximum Out‐of‐Pocket (MOOP) for the Value plan?
- A.
$4,950
- B.
$4,450
- C.
$4,250
- D.
$5,000
Correct Answer
D. $5,000Explanation
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.Rate this question:
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- 16.
There is a $65 copayment for Emergency Visits for all BlueCHiP for Medicare Advantage plans?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 17.
Blue Cross Blue Shield of Rhode Island pharmacy Benefit Manager is Catamaran?
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 18.
In the Select Network, a member will not be able to see any Specialist of their choice?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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- 19.
How many Skilled Nursing Facilities are part of the Select Network?
- A.
77
- B.
7
- C.
11
- D.
80
Correct Answer
C. 11 -
- 20.
Which hospital is not included in the Select Network?
- A.
South County
- B.
Memorial
- C.
Landmark
- D.
Miriam
Correct Answer
D. MiriamExplanation
Miriam hospital is not included in the Select Network.Rate this question:
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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.
A, B, C
- B.
B and D
- C.
B and E
- D.
B, C, and D
Correct Answer
B. B and DExplanation
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.Rate this question:
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- 22.
Does the Select plan have a Point‐of‐Service (POS) benefit?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The Select plan does not have a Point-of-Service (POS) benefit.Rate this question:
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- 23.
What is the inpatient hospital stay for days 1‐5 for the Extra plan?
- A.
$190
- B.
$285
- C.
$350
- D.
$275
Correct Answer
D. $275Explanation
The inpatient hospital stay for days 1-5 for the Extra plan is $275.Rate this question:
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- 24.
What is the prescription drug deductible for the Extra plan?
- A.
$200
- B.
$320
- C.
$100
- D.
None
Correct Answer
D. NoneExplanation
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.Rate this question:
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- 25.
Are hearing aids covered on the Extra plan?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Hearing aids are not covered on the Extra plan.Rate this question:
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- 26.
What is the outpatient surgery cost‐sharing for the Value plan?
- A.
$150
- B.
$175
- C.
20%
- D.
35%
Correct Answer
C. 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%.Rate this question:
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- 27.
What is the inpatient hospital stay for days 1‐5 for the Select plan?
- A.
$275
- B.
$345
- C.
$180
- D.
$285
Correct Answer
D. $285Explanation
The inpatient hospital stay for days 1-5 for the Select plan is $285.Rate this question:
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- 28.
What is the Maximum Out‐of‐Pocket (MOOP) for the Extra?
- A.
$5,000
- B.
$2,800
- C.
$4,250
- D.
$3,750
Correct Answer
D. $3,750Explanation
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.Rate this question:
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- 29.
Which plan has prescription drug coverage through the Gap?
- A.
Extra
- B.
Preferred
- C.
Plus
- D.
Select
Correct Answer
B. PreferredExplanation
Preferred plan has prescription drug coverage through the Gap.Rate this question:
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- 30.
If a member sees a primary care physician outside of the Select network, they would pay a $0 copayment.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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Current Version
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Mar 19, 2023Quiz Edited by
ProProfs Editorial Team -
Sep 23, 2014Quiz Created by
Bthorup
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