2025 AmeriHealth Caritas SCBy Brian Platte / July 25, 2024 First Choice VIP Care covers all counties in South Carolina except Darlington County. True False Referrals are not needed for Specialist with the First Choice VIP Care plans. True False SLMB Plus and QMB Plus members are responsible to pay their Part B premium. True False Some of the VIP members will have to pay Part C cost-sharing, Part B premium, or deductible. True False Which key documents should an agent always have available when meeting a prospect? Attestation of Eligibility Enrollment Application Pre-Enrollment Checklist All of the above The supplemental benefits for both plans will include a Meal Benefit for those who have been discharged from Inpatient Hospital stay or Skilled Nursing Facility and received a referral. True False These plans offer the SilverSneakers fitness benefit. The benefit includes ____________. Access to participating SilverSneakers facilities Online wellness resources Classes All of the above If a member requires more than a 7-day supply of an opioid prescription, the member or his/her provider will have to submit a prior authorization demonstrating medical necessity for an opioid supply greater than a 7-day supply. True False First Choice VIP Care cover four dental X-rays every year. True False First Choice VIP Care members do not have a deductible for Part D drug. True False Members have 2-hour, 7 day a week access to a physician via the Telemedicine benefit. True False Cultural competence refers to the ability to demonstrate in a competent manner toward beneficiaries with diverse values, beliefs, and behaviors. What are the needs to be considered for effective cross-cultural communication? Economical, Educational, and Geographical needs Social, Cultural, linguistic needs First Choice VIP Care offers a combined annual coverage of $50,000 Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation. True False A Prior Authorization is needed for the following services. Inpatient psychiatric hospital Podiatry Services Emergency Ambulance services QMB+ members receive full Medicaid benefits. True False First Choice VIP Care offers up to three fitting evaluations for hearing aid once a year. True False Which statement is true for First Choice VIP members for transportation benefit? 48 one-way trips per year 50 one-way trips per year 100 one-way trips per year Unlimited one-way trips per year Will First Choice VIP Care cover out of network providers? Yes No Which sentence is correct to describe the eligibility requirements to enroll in the plans? Live in the service area Enrolled in Medicare Part A and B Is enrolled in the Pennsylvania Medicaid program All of the above Which dual eligible categories, for First Choice VIP Care, are able to enroll? QMB and QMB+ and SLMB+ QMB+, SMLB+, and FBDE QMB, SLMB, and QI QI and QDWI ResultsVote
