#1
Which federal agency oversees compliance with Medicare Advantage plans?
Centers for Medicare & Medicaid Services (CMS)
ExplanationCMS oversees compliance with Medicare Advantage plans.
#2
What is a key feature of Medicare Advantage plans?
They often include prescription drug coverage
ExplanationPrescription drug coverage is a key feature of Medicare Advantage plans.
#3
What is the 'Open Enrollment Period' for Medicare Advantage?
October 15th to December 7th
ExplanationOpen Enrollment for Medicare Advantage is from October 15th to December 7th.
#4
Which of the following individuals is eligible for a Medicare Advantage plan?
Someone with both Medicare Part A and Part B
ExplanationThose with both Medicare Part A and Part B are eligible for Medicare Advantage.
#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)
ExplanationCMS regulates Medicare Advantage plans to ensure compliance with Medicare rules.
#6
Which of the following is a true statement about Medicare Advantage plans?
They may offer additional benefits beyond what Original Medicare covers
ExplanationMedicare Advantage plans may provide additional benefits beyond Original Medicare coverage.
#7
Which of the following is NOT a type of Medicare Advantage plan?
Fee-for-Service (FFS)
ExplanationFee-for-Service (FFS) is not a type of Medicare Advantage plan.
#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
ExplanationANOC is a document detailing changes in plan benefits and costs for the next year.
#9
What is the Star Rating system used for in Medicare Advantage plans?
To assess the quality and performance of plans
ExplanationThe Star Rating system assesses the quality and performance of Medicare Advantage plans.
#10
Which of the following statements about Medicare Advantage Special Needs Plans (SNPs) is true?
They tailor their benefits to specific groups of beneficiaries
ExplanationSNPs tailor their benefits to specific groups of beneficiaries.
#11
Which of the following healthcare services is typically covered by Medicare Advantage plans?
Routine dental care
ExplanationMedicare Advantage plans typically cover routine dental care.
#12
What is the purpose of the Medicare Advantage Disenrollment Period?
To allow beneficiaries to switch from a Medicare Advantage plan to Original Medicare
ExplanationDisenrollment Period allows switching to Original Medicare from Medicare Advantage.
#13
What is the maximum out-of-pocket limit for Medicare Advantage plans in 2022?
$7,550
ExplanationThe maximum out-of-pocket limit for Medicare Advantage plans in 2022 is $7,550.
#14
Which of the following is a consequence of non-compliance with Medicare Advantage regulations?
Sanctions imposed on the plan, including financial penalties
ExplanationNon-compliance with regulations leads to sanctions, including financial penalties.
#15
What is the difference between Medicare Advantage and Medigap?
Medicare Advantage plans provide additional coverage beyond what Original Medicare covers, while Medigap plans fill in the 'gaps' in Original Medicare coverage
ExplanationMedicare Advantage provides additional coverage, while Medigap fills in Original Medicare gaps.
#16
Which federal law governs the marketing practices of Medicare Advantage plans?
MAA (Medicare Advantage Advertising Act)
ExplanationThe MAA governs the marketing practices of Medicare Advantage plans.
#17
Which of the following is a requirement for Medicare Advantage plans regarding provider networks?
Plans must maintain a network of contracted healthcare providers
ExplanationMedicare Advantage plans must maintain a network of contracted providers.
#18
What is the purpose of the Special Election Period (SEP) for Medicare Advantage plans?
To allow beneficiaries to enroll in or switch Medicare Advantage plans outside of the typical enrollment periods due to certain life events
ExplanationSEP allows enrollment or switching of Medicare Advantage plans outside typical periods due to life events.
#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
ExplanationPrior authorization in Medicare Advantage requires approval from Medicare before certain medical services.