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    mrs. tanner is enrolled in a medicare advantage hmo that offers a point of service option. this allows mrs. tanner to do which of the following?

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    get mrs. tanner is enrolled in a medicare advantage hmo that offers a point of service option. this allows mrs. tanner to do which of the following? from EN Bilgi.

    Mrs Tanner can go to non plan doctors without receiving prior approval for all

    Mrs Tanner can go to non plan doctors without receiving prior approval for all from NUR COMMUNITY at St. Edward's University

    Mrs tanner can go to non plan doctors without

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    Mrs. Tanner can go to non-plan doctors without receiving prior approval for all services.

    Mrs. Park has a low, fixed income.What could you tell her that might be of assistance?

    Get answer to your question and much more

    You have decided to focus on doing in-home presentations to market the Medicare Advantage(MA) plans you represent.Before you conduct such sales presentations, what must you do?

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    Pharmacology, Medicare Part D

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    What is an HMO POS Medicare Advantage Plan?

    What is an HMO POS Medicare Advantage Plan?

    Support Center

    Questions and Answers on Medicare Part D

    FAQs on Medicare Advantage Plans (MAPD)

    What is an HMO POS Medicare Advantage Plan?

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    What is an HMO POS Medicare Advantage Plan?

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    An HMO POS is a Health Maintenance Organization with a Point of Service Option.

    An HMO POS is a Medicare Advantage Plan that is a Health Maintenance Organization with a more flexible network allowing Plan Members to seek care outside of the traditional HMO network under certain situations or for certain treatment.

    A Member may pay some additional fees for using the POS (out-of-network) option.

    If I join an HMO-POS...

    Can I get my health care from any doctor, other health care provider, or hospital?

    You generally get your care and services from doctors, other health care providers, or hospitals in the plan's network (except emergency care, out-of-area urgent care, or out-of-area dialysis).  However, you may be able to go out-of-network for certain services, usually for a higher cost.

    Are prescription drugs covered?

    In most cases, yes.  If you want Medicare drug coverage, you must join an HMO plan that offers prescription drug coverage (MAPD).

    Do I need to choose a primary care doctor?

    In most cases, yes.

    Do I have to get a referral to see a specialist?

    In most cases, yes.  Certain services, like yearly screening mammograms, don't require a referral.

    What else do I need to know about this type of plan?

    If your doctor or other health care provider leaves the plan's network, your plan will notify you.  You many choose another doctor in the plan's network.

    If you get health care outside the plan's network, you may have to pay the full cost.

    It is important that you follow the plan's rules, like getting prior approval for a certain service when needed.

    If you need more information than listed here, check with the plan.  You can find the plan's member services telephone number by clicking on the "benefits & contact info" button on our MA-Finder.com.

    Click here to learn more about Medicare Advantage Plans.

    Still have more questions? Click here to let us know.

    Browse 2022 Medicare Part D prescription drug plansBrowse 2022 Medicare Advantage plans (MAPD)

    Sign-up for our Medicare Part D Newsletter.

    Still have a question? Click here to let us know.

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    Source : q1medicare.com

    AHIP

    紐約哈德遜廣場(Hudson Yards)的著名建築The Vessel前段日子宣布無限期關閉了。沒錯,就是我們前一兩個月就有跟大家更新過的自殺跳樓事件頻發的網紅地標。而在剛步入2021年不到兩個星期的1月11號,這裡又發生了一起自殺跳樓案件。

    AHIP-Question

    January 19, 2021 by Queenie

    7,306 Views

    Mr. Romero is 64, retiring soon, and considering enrollment in his employer-sponsored retiree group health plan that includes drug coverage with nominal copays.  He heard about a neighbor’s MA-PD plan that you represent and because he takes numerous prescription drugs, he is considering signing up for it. What should you tell him?

    a.

    Generally, employers prefer retirees to have both the retiree group plan and the MA-PD plan to fill in the gaps, but he would be better off with just the MA-PD plan.

    b.

    He should compare the benefits in his employer-sponsored retiree group health plan with the benefits in his neighbor’s MA-PD plan to determine which one will provide sufficient coverage for his prescription needs.

    c.

    Generally, employers prefer retirees to enroll in a stand-alone PDP, so he should consider that instead of the MA-PD.

    d.

    When possible, it is always the best option to have both the employer’s plan and the MA-PD, so he would have no out-of-pocket expenses.

    Contents hide

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    Question 2

    Not yet answered

    Question text

    Mr. Rainey is experiencing paranoid delusions and his physician feels that he should be hospitalized.  What should you tell Mr. Rainey (or his representative) about the length of an inpatient psychiatric hospital stay that Medicare will cover?

    a.

    Medicare will cover, at its allowable amount, as many stays as are needed throughout Mr. Rainey’s life, as long as no single stay exceeds 190 days.

    b.

    Inpatient psychiatric services are not covered under Original Medicare.

    c.

    Medicare will cover a total of 190 days of inpatient psychiatric care during Mr. Rainey’s entire lifetime.

    d.

    Medicare inpatient psychiatric coverage is limited to the same number of days covered for typical inpatient stays.

    Question 3

    Not yet answered

    Question text

    During a sales presentation, your client asks you whether the Medicare agency recommends that she sign up for your plan or stay in Original Medicare.  What should you tell her?

    a.

    Tell her that, because you represent a Medicare health plan, you therefore work for Medicare, and the information you offer her is a good basis of any decision she makes.

    b.

    Tell her that the Medicare agency does not endorse or recommend any plan.

    c.

    Tell her that Medicare recommends that beneficiaries enroll in a Medicare Advantage plan because it will serve her better than Original Medicare.

    d.

    Tell her that Medicare or CMS (the Medicare agency) has approved and endorsed the plan.

    Question 4

    Not yet answered

    Question text

    Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D Prescription Drug program and he is wondering if there is any other option he has for obtaining help with his considerable drug costs.  What should you tell him?

    a.

    He should contact his neighbors and family members and let them know that any contributions they make toward his drug expenses will be tax deductible.

    b.

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