Jeremy Lai in 福利

UHC – Which of the following is not a correct statement about in-network provider services?

Which of the following is not a correct statement about in-network provider services?

HMO-POS Plans only cover in-network services.

Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months, and being any age with ESRD or ALS are each eligibility requirements for which program?

Original Medicare

Which of the following defines a Medicare Advantage (MA) Plan? (Select 2)

MA Plans must provide benefits equivalent to Original Medicare, and most plans also offer additional benefits.
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MA Plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage.

Larry wants to enroll in a 2021 Medicare Advantage plan. He has End Stage Renal Disease (permanent kidney failure). What eligibility requirements must he meet? (Select the two answers that apply.)

Reside in the plan’s service area
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Entitled to Medicare Part A and enrolled in Part B

Member Doug enrolled in a Health Maintenance Organization (HMO) MA Plan. He saw an out-of-network doctor and received a bill for the entire cost of the visit. Doug called Medicare to complain and stated he was never told about these types of costs. What should the agent have explained better to Doug when he was enrolling in the plan? (Select 3)

That Doug must receive covered services from contracted network providers.
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That exceptions to the provider network requirement are emergency visits, urgent care and renal dialysis services, which can be obtained from out-of-network providers.
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That in most cases, Doug will pay the entire cost of the service if he sees an out-of-network provider.