Smmc Refresher Quiz #7

7 Questions | Total Attempts: 202

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Smmc Refresher Quiz #7 - Quiz

Coordination of Dual Eligible Services


Questions and Answers
  • 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.

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