Smmc Refresher Quiz #7
Coordination of Dual Eligible Services
- 1.
A recipient wants to know if they need to choose a new PCP through their MMA plan if they already see a PCP through Medicare. Which is the correct answer?
- A.
Advise the recipient that they are only able to have an MMA PCP.
- B.
Advise the recipient they do not have to have a PCP through MMA or Medicare.
- C.
Advise the recipient that if they have a Medicare PCP, they do not have to choose a new PCP through the MMA plan.
- D.
Advise the recipient that they are only able to have a Medicare PCP.
Correct Answer
C. Advise the recipient that if they have a Medicare PCP, they do not have to choose a new PCP through the MMA plan. -
- 2.
What eligibility category will this recipient have?
- A.
The recipient will be Mandatory.
- B.
The recipient will be Voluntary.
- C.
The recipient will be Excluded.
- D.
The recipient will not be eligible.
Correct Answer
C. The recipient will be Excluded. -
- 3.
A recipient wants to know what kind of coverage they have. While reviewing the case, you see the recipient is only eligible for QMB. What can you inform them?
- A.
Inform the recipient that QMB means they are covered by Medicare, not Medicaid. Refer to Medicare.
- B.
Inform the recipient that QMB is a cost-sharing program that will have Medicaid cover the Medicare premiums, deductibles, and coinsurance.
- C.
Inform the recipient that QMB isn’t a real eligibility. Refer to DCF/SSA to change their eligibility to Mandatory to enroll into an MMA plan.
- D.
Inform the recipient that QMB is a program that covers more than MMA plans for recipients who are Dual Eligible.
Correct Answer
B. Inform the recipient that QMB is a cost-sharing program that will have Medicaid cover the Medicare premiums, deductibles, and coinsurance. -
- 4.
What eligibility category will this recipient have?
- A.
The recipient will be Mandatory.
- B.
The recipient will be Voluntary.
- C.
The recipient will be Excluded.
- D.
The recipient will not be eligible.
Correct Answer
A. The recipient will be Mandatory. -
- 5.
A recipient wants to know why they have QMB eligibility and not full Medicaid. How should you proceed?
- A.
Advise the recipient that it is because everyone with Medicare has QMB through Medicaid.
- B.
Refer the recipient to the AHCA Medicaid Helpline for more information on QMB Eligibility.
- C.
Advise the recipient it is because they do not make enough money to enroll into an MMA plan.
- D.
Refer the recipient to DCF for more information on QMB Eligibility.
Correct Answer
D. Refer the recipient to DCF for more information on QMB Eligibility. -
- 6.
A Dual Eligible recipient wants to know what MMA plan works best with their Medicare plan. What information can you provide?
- A.
Refer the recipient to Medicare to see which MMA plans work with their Medicare plan.
- B.
Advise the recipient it doesn't matter which MMA plan they choose, because they all work the same regardless of which Medicare plan they have.
- C.
Refer the recipient to the MMA plans to see which one works with their Medicare plan.
- D.
Refer the recipient to the AHCA Medicaid Helpline to see which MMA plan works with their Medicare Plan.
Correct Answer
A. Refer the recipient to Medicare to see which MMA plans work with their Medicare plan. -
- 7.
What eligibility category will this recipient have?
- A.
The recipient will be Mandatory.
- B.
The recipient will be Voluntary.
- C.
The recipient will be Excluded.
- D.
The recipient will not be eligible.
Correct Answer
B. The recipient will be Voluntary. -
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Current Version
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Mar 21, 2022Quiz Edited by
ProProfs Editorial Team -
May 08, 2017Quiz Created by
AHSFLTrainer
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