2015 Cdphp
- 1.CDPHP’s Medicare Advantage plans have a yearly deductible.
- A.
Yes – members must pay $147 each year
- B.
No – There are no deductibles on any CDPHP individual Medicare Advantage plans
- 2.On the 2015 Basic RX (HMO) Plan, the inpatient hospital copay is __________:
- A.
$275 per admission
- B.
$275/day (Days 1-5) & $0/day (Days 6+)
- C.
$400 per admission
- D.
$700 per admission
- 3.The premium for Core RX (PPO) is _______:
- A.
$134.50
- B.
$138.00
- C.
$194.50
- D.
$276.50
- 4.A person on Choice Rx (HMO) undergoing therapeutic radiology treatments will pay what amount for each treatment?
- A.
$20
- B.
$25
- C.
$40
- D.
$60
- 5.If a member goes to an out-of-network specialist on the Core RX (PPO) plan the copay is ________:
- A.
$30
- B.
$40
- C.
$50
- D.
$60
- 6.The emergency room copay for Choice RX (HMO) is _______?
- A.
$35
- B.
$40
- C.
$50
- D.
$65
- 7.Included in CDPHP’s Health and Wellness Programs are:
- A.
Complementary & Alternative Medicine (CAM)
- B.
Health Coach Connection
- C.
Senior Fit
- D.
All of the above
- 8.The premium for CDPHP’s Basic RX (HMO) Plan is ________?
- A.
$29.50
- B.
$40.00
- C.
$45.50
- D.
$95.50
- 9.The Choice (HMO) Plan is the only CDPHP Medicare Advantage (HMO/PPO) plan without drug coverage?
- A.
True
- B.
False
- 10.The premium for Prime Rx (PPO) is ________:
- A.
$134.50
- B.
$138.00
- C.
$194.50
- D.
$276.50
- 11.The copay for ambulance services on the Basic Rx (HMO) plan is _______:
- A.
$50
- B.
$125
- C.
$175
- D.
$225
- 12.The monthly premium for Choice (HMO) is _______:
- A.
$29.50
- B.
$32.00
- C.
$40.00
- D.
$45.50
- 13.On the Choice Rx (HMO) plan the member will pay how much for a Part B drug:
- A.
20% coinsurance
- B.
$0 copayment
- C.
$35 copayment
- D.
$40 copayment
- 14.The copay for an x-ray on the Value RX (HMO) plan is _______:
- A.
$0
- B.
$25
- C.
$30
- D.
$60
- 15.The inpatient hospital out-of-network copay for Classic Rx (PPO )is ________:
- A.
$400
- B.
$600
- C.
$1,000
- D.
$1,200
- 16.The urgent care copay for Prime Rx (PPO) is ________:
- A.
$35
- B.
$50
- C.
$65
- D.
$75
- 17.On the Core Rx (PPO) plan, the in-network copay for chiropractic services is _________:
- A.
$15
- B.
$20
- C.
$40
- D.
$60
- 18.The copay for an outpatient surgery performed in an ambulatory surgical center under the Choice Rx (HMO) plan would be:
- A.
$100
- B.
$125
- C.
$150
- D.
$175
- 19.What will a member pay for a routine hearing exam under the Basic RX (HMO) plan?
- A.
$20
- B.
$30
- C.
$40
- D.
$50
- 20.Senior Fit is a no-cost program that includes access to the Silver Sneakers program for all of our Medicare Advantage members.
- A.
True
- B.
False
- 21.The initial coverage level for Part D prescription drug coverage is _______:
- A.
$2,850
- B.
$2,930
- C.
$2,960
- D.
$4,700
- 22.On the Choice Rx (HMO) plan a member will pay what amount for a 30-day supply of a Tier 3 Preferred Brand drug in the Initial Coverage Level?
- A.
$11
- B.
$40
- C.
$45
- D.
$95
- 23.On the Core Rx (PPO) plan a member will pay what amount for a 90-day supply of a Tier 4 Non-Preferred Brand drug in the coverage gap or donut hole?
- A.
$45
- B.
$95
- C.
45% of retail cost of the drug
- D.
65% of retail cost of the drug
- 24.When a member reaches Catastrophic coverage, in any of CDPHP’s Medicare Advantage plans, what amount will they pay for a generic or multi-source drug?
- A.
$0
- B.
5% or $2.65 whichever is less
- C.
5% or $2.65 whichever is greater
- D.
$6.60
- 25.On the Prime Rx (PPO) plan, what will the member pay for a 90-day supply purchased through mail order for a Tier 2 Non-Preferred generic drug while in the coverage gap?
- A.
$0
- B.
$8
- C.
$16
- D.
$24
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