AETNA MA/MAPD/DSNP EXAM 2023-2024 ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|AGRADE

AETNA MA/MAPD/DSNP EXAM 2023-2024 ACTUAL EXAM 100

QUESTIONS AND CORRECT DETAILED ANSWERS WITH

RATIONALES|AGRADE

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 - ANSWER- E) All of the above

The Aetna DSNP care manager and care team provide a single point-ofcontact to help coordinate all Medicare and Medicaid covered care and

services that the member needs.

True or False - ANSWER- True

Enrollment Hierarchy - ANSWER- icep/ iep

ma oep/ ma oep new

sep

aep

oepi

Initial Coverage election period icep - ANSWER- begins three months

before the individuals entitlement to both medicare a and b

For MA - only enrollments with a few exceptions

Initial election period iep - ANSWER- For Part D coverage, so it can be

used for enrollement into MAPD or standalone PDP

3 months before entitlement to part a and b begin, and three months after

If a benefiary is going into, leaving or residing in a nursing home and

wishes to enroll in a MAPD plan, they would use which enrollment

period? - ANSWER- OEP-1

If a newly eligible beneficiary wants to enroll in a MA only plan, what

enrollment period can they use? - ANSWER- ICEP

When a beneficiary is first eligible for a drug plan and wishes to enroll

in a MAPD or PDP plan which enrollment period would they use? -

ANSWER- IEP

Mr. Bencomo tells you that he has not been eligible for Medicaid for a

month now and wants to change his MAPD plan today. Can he do this

and if yes what enrollment period would he use? - ANSWER- SEP

The SEP for beneficiaries with a chronic condition - ANSWER- allows a

beneficiary with severe or disabling chronic conditions to enroll in a

SNP designed to serve beneficiaries with those conditions

The SEP for employer group health can be used when - ANSWER- a

beneficiary is informed that they are losing their group retirement plan

a beneficiary chooses to retire/resign and enroll in a MA/MAPD or PDP

a beneficiary decides not to continue with their group retirement plan

and wishes to enroll in a MA/MAPD or PDP plan

If a beneficiary is disenrolled from a MAPD because they stopped

paying their part b premium - ANSWER- use the sep for ivoluntarily

disenrolled from MAPD due to loss of part b to enroll into a standalone

Aetna offers a variety of Aetna Medicare Advantage plan types. Which

plan type requires a person to use only network providers? (Excluding

emergency or urgently needed services)

a.

PDP plan

b.

HMO plan

c.

PPO plan

d.

ESRD plan - ANSWER- b.

HMO plan