#1
Which federal agency oversees compliance with Medicare Advantage plans?
Centers for Disease Control and Prevention (CDC)
Centers for Medicare & Medicaid Services (CMS)
Food and Drug Administration (FDA)
National Institutes of Health (NIH)
#2
What is a key feature of Medicare Advantage plans?
They cover only hospital stays
They require a referral to see a specialist
They often include prescription drug coverage
They are available only to low-income individuals
#3
What is the 'Open Enrollment Period' for Medicare Advantage?
January 1st to March 31st
October 15th to December 7th
July 1st to August 31st
Varies depending on the individual's birthday
#4
Which of the following individuals is eligible for a Medicare Advantage plan?
Someone with only Medicare Part A
Someone with both Medicare Part A and Part B
Someone with only Medicare Part B
Someone with Medicaid but not Medicare
#5
Which federal agency is responsible for regulating Medicare Advantage plans to ensure compliance with Medicare rules and regulations?
Centers for Medicare & Medicaid Services (CMS)
Food and Drug Administration (FDA)
Federal Trade Commission (FTC)
Department of Health and Human Services (HHS)
#6
Which of the following is a true statement about Medicare Advantage plans?
They are only available to individuals aged 75 and older
They are standardized, meaning all plans offer the same coverage
They are administered directly by the federal government
They may offer additional benefits beyond what Original Medicare covers
#7
Which of the following is NOT a type of Medicare Advantage plan?
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Fee-for-Service (FFS)
Special Needs Plan (SNP)
#8
In Medicare Advantage plans, what is the 'Annual Notice of Change' (ANOC)?
A document outlining changes in plan benefits and costs for the next year
A form for new enrollees to sign up for coverage
A requirement for beneficiaries to update their personal information annually
A summary of Medicare regulations for providers
#9
What is the Star Rating system used for in Medicare Advantage plans?
To determine eligibility for enrollment
To assess the quality and performance of plans
To calculate premiums for beneficiaries
To assign beneficiaries to specific doctors
#10
Which of the following statements about Medicare Advantage Special Needs Plans (SNPs) is true?
They are available to all Medicare beneficiaries
They are only for beneficiaries with end-stage renal disease (ESRD)
They offer the same benefits as Original Medicare
They tailor their benefits to specific groups of beneficiaries
#11
Which of the following healthcare services is typically covered by Medicare Advantage plans?
Elective cosmetic surgery
Routine dental care
Experimental treatments
Long-term care in a nursing home
#12
What is the purpose of the Medicare Advantage Disenrollment Period?
To allow beneficiaries to switch from Original Medicare to a Medicare Advantage plan
To allow beneficiaries to switch from a Medicare Advantage plan to Original Medicare
To allow beneficiaries to switch from one Medicare Advantage plan to another
To allow beneficiaries to switch from one Medigap plan to another
#13
What is the maximum out-of-pocket limit for Medicare Advantage plans in 2022?
$5,000
$7,550
$10,000
$15,000
#14
Which of the following is a consequence of non-compliance with Medicare Advantage regulations?
Immediate termination of the beneficiary's coverage
Fine imposed on the beneficiary
Sanctions imposed on the plan, including financial penalties
Automatic enrollment in traditional Medicare
#15
What is the difference between Medicare Advantage and Medigap?
Medicare Advantage plans are sold by private insurance companies, while Medigap plans are offered by the government
Medicare Advantage plans cover prescription drugs, while Medigap plans do not
Medicare Advantage plans provide additional coverage beyond what Original Medicare covers, while Medigap plans fill in the 'gaps' in Original Medicare coverage
There is no difference; the terms 'Medicare Advantage' and 'Medigap' are interchangeable
#16
Which federal law governs the marketing practices of Medicare Advantage plans?
HIPAA (Health Insurance Portability and Accountability Act)
COBRA (Consolidated Omnibus Budget Reconciliation Act)
ACA (Affordable Care Act)
MAA (Medicare Advantage Advertising Act)
#17
Which of the following is a requirement for Medicare Advantage plans regarding provider networks?
Plans must offer out-of-network coverage for all services
Plans must maintain a network of contracted healthcare providers
Plans are not allowed to have provider networks
Plans can change their provider network at any time without notifying beneficiaries
#18
What is the purpose of the Special Election Period (SEP) for Medicare Advantage plans?
To allow beneficiaries to switch from Original Medicare to a Medicare Advantage plan
To allow beneficiaries to enroll in or switch Medicare Advantage plans outside of the typical enrollment periods due to certain life events
To allow beneficiaries to switch from a Medicare Advantage plan to Original Medicare
To allow beneficiaries to enroll in Medigap coverage
#19
What is 'prior authorization' in the context of Medicare Advantage plans?
A requirement for beneficiaries to obtain approval from Medicare before receiving certain medical services
A form that beneficiaries fill out to enroll in a plan
A process for beneficiaries to switch from one Medicare Advantage plan to another
An annual notification of changes in plan benefits and costs