Medicare D Plan Types

Question 1

True or False: PDP stands for Prescription Drug Plan

Answer 1

False: PDP stands for Part D Plan

Question 2

True or False: Medicare D is functionally run by the federal government

Answer 2

False: Medicare D is overseen by the federal government, but run by private health insurers.

Question 3

Navitus currently has clients for four different plan types. Name two.

Answer 3

EGWP
MMP
MAPD
PACE

Question 4

Navitus handles member calls for ________

Answer 4

EGWP

Question 5

There are four phases in a standard Medicare D plan year. They are:

a. Deductible, Internal Affairs, Gap, Free-for-All
b. Deductible, Initial Coverage, Donut Hole, Cadillac
c. Deductible, Initial Coverage, Gap, Catatonic
d. Deductible, Initial Coverage, Gap, Catastrophic

Answer 5

The correct answer is D.

Question 6

The Catastrophic phase is so named because _____

Answer 6

The amount spent by the plan to get to the fourth phase in a single year is considered catastrophic for the plan.

Question 7

True or False : Some plans will choose to allow their members to bypass the deductible.

Answer 7

True. As far as Medicare is concerned, the Deductible is still happening, however the plan may choose to pick up the difference between the member copay and the cost of the drug.

Question 8

MMP is _______

Answer 8

Any of the below are correct:
A Medicare-Medicaid plan.
A “Demonstration” plan.
Very rare.

Question 9

True or False: All Part C plans are MAPD plans.

Answer 9

False : Part C plans MAY include part D, and if so are considered Medicare Advantage Part D plans. However, a Part C plan does not necessarily have to include a part D plan. Thus all MAPD plans are Part C plans, but not all Part C plans are MAPD plans.

Question 10

PACE plans are ______

Answer 10

Comprehensive coverage plans that are specifically targeted to the most vulnerable medicare members.