Social Sciences > QUESTIONS & ANSWERS > Aetna Individual MA/MAPD/DSNP Quiz with Certified Solutions (All)

Aetna Individual MA/MAPD/DSNP Quiz with Certified Solutions

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Aetna Individual MA/MAPD/DSNP Quiz with Certified Solutions Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a person to use only network providers? (Excludin... g emergency or urgently needed services) ✔✔HMO plan Which plan type allows members to see preferred doctors in network, doctors out-of-network, and does not require referrals to a specialist? ✔✔PPO plan Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they are called MAPD plans. ✔✔True Aetna case management consists of registered nurses, social workers, behavioral health professionals and pharmacists who help members navigate the health care system and access services. ✔✔True Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum. ✔✔False Aetna Medicare Advantage HMO and PPO plans cover routine preventive care including an annual wellness visit, screening mammograms, and prostate cancer screenings. ✔✔True A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy. ✔✔True All MAPD plans have a prescription drug component. ✔✔True You can find a quick list of tools for Aetna Medicare plans on https://www.aetnamedicare.com/en/for-producers.html, which includes information about plans, medications, and doctors. ✔✔True A full dual eligible means an individual has Medicare but is only eligible for assistance with Medicare premiums and sometimes cost share through the Medicare Saving Program. ✔✔False One of Aetna's Model of Care goals is to improve use of preventive health services. ✔✔True The Aetna DSNP care manager and a care team provide a single point-of-contact to help coordinate all Medicare and Medicaid covered care and services that the member needs. ✔✔True [Show More]

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