Aetna 2025 MA/MAPD/DSNP Questions And Answers Graded A+
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Course
Aetna 2025 MA/MAPD/DSNP
Institution
Aetna 2025 MA/MAPD/DSNP
Each pharmacy component of an MAPD plan consists of a formulary, a pharmacy network and benefit
designs (cost sharing and tier structure).
Select one:
True
False - True
What is a Special Needs Plan (SNP)?
a.A type of Medicare Advantage Prescription Drug (MAPD) coordinated care plan that limit...
Each pharmacy component of an MAPD plan consists of a formulary, a pharmacy network and benefit
designs (cost sharing and tier structure).
Select one:
True
False - True
What is a Special Needs Plan (SNP)?
a.A type of Medicare Advantage Prescription Drug (MAPD) coordinated care plan that limits enrollment
to people with specific diseases or characteristics.
b.An MA plan that tailors benefits, provider choices, and drug formularies to meet specific needs of the
groups they serve.
c.An MA plan for those who are eligible for Medicare and Medicaid.
d.A MA plan required to contract with a state Medicaid agency.
e.
All of the above - e.
All of the above
Which of the following is true for Low Income Subsidy?
a.Beneficiaries pay no more than $3.95 for a covered generic and $9.85 for each brand name drug
b.There is no coverage gap
c.There is no Late Enrollment Penalty
d.All of the above - d.All of the above
Which are attributes of the Aetna's Model of Care?
a.An Interdisciplinary Care Team approach
b.Clinical programs to improve health and well-being
, c.Transition of Care Program
d.A and B
e.
All of the above - e.
All of the above
Which plan type allows members to see preferred doctors in network, doctors out-of-network, and does
not require referrals to a specialist?
a.
PDP plan
b.
Cost plan
c.
PPO plan
d.
HMO plan - c.
PPO plan
All of our HMO and PPO plans include a maximum out-of-pocket limit.
Select one:
True
False - True
Which of the following statements are true?
a.
If PPO members see a doctor who is not in the network their cost share for services may be higher
b.
In the Aetna Medicare Open Access HMO plan, members can go to any Aetna Medicare plan HMO
network doctor they choose for covered services, without a PCP referral, as long as the doctor is a
contracted HMO doctor.
c.
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