Med D Part 1

1.

1 point

If the client intent shows a deductible on the Accumulators tab AND on the LICs tab, the tester must build deductible claims for LICs 5?

True

False

2.

1 point

With GAP WRAP, members may receive a 50% discount for which type of qualifying drugs?

Generic

Brand

3.

1 point

Which of the following Rumba screens would be used to verify the price point of an NDC?

MSMN > 40 > 1

MSMN > 29 > 2

MSMN > 90 > 10

MSMN > 92 > 4

4.

1 point

CMS stands for Center for Medical Services.

True.

False. CMS stands for Center for Medicare and Medicaid Services.

5.

1 point

When the tester clicks the "Create Claims" button on the Work Manager-SR Details screen, what must they wait for?

An error message

A message that reads: "Your Claims Have been Created Successfully"

A phone call

All of the above

None of the above

6.

1 point

The year is 2015. It’s a Tuesday, and your Great Aunt Gertrude keeps complaining about being “in the Donut Hole” …which of the below statements is an accurate interpretation of what she is saying?

Who knows? She's probably just hungry.

She’s still paying towards her Med D plan deductible

Her TrOOP paid amount is over $4,700 and she is now enjoying low, low copays of $2.65 or 5% for generic drugs.

Gertrude’s Drug Spend Limit is greater than $2,960, but her TrOOP is below $4,700, putting her in the GAP stage of her Med D coverage.

7.

1 point

You have just created an input grid using the automation tool and you notice that strangely, all of the NDCs for Price Point 7 on your input grid are 00000000000…what should you do?

Find an NCD using FRS

E-mail CBA for an NDC

Use Rumba to find an NDC

Delete the claims. There are no NDCs for Price Point 7 at this time.

8.

1 point

Yesterday your Great Uncle Albert reached the Catastrophic Stage of his Medicare D coverage. What does that mean?

He's paying a lower copay, but it will vary based on the plan design.

He'll pay only $2.65 or 5% for generic drugs and $6.60 or 5% for brand.

He'll pay up to 65% for generics, and could pay as much as 95% for brand drugs.

I'm not sure, but it sounds really bad.

9.

1 point

Medicare will cover a cardholder, their spouse and up to 2 children.

True.

False. Medicare covers individuals only.

10.

1 point

Which of the following are considered Med D benefit stages?

Catastrophic

Initial Coverage

Coverage Gap

Deductible

All of the above

11.

1 point

ALL Med D benefits have a deductible stage.

True

False

12.

1 point

You are working an SR with 20 grids total. Under your WMID, you are assigned grids 1-5. After many days of labor, you have completed your work. In Houston, you see that there are two other Testing activities still set to ‘In Progress’ that are not assigned to you, what should you do?

Cry

Change all testing activities to ‘Done’, attach your zip and close the SR

Change only YOUR testing activity to ‘Done’, attach your zip and go on your merry way.

Do nothing.