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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
Questions: 100 | Attempts: 2677 | Last updated: Mar 21, 2022
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