2025 BCBS of AZ Pathway DSNP Certification ExamBy Brian Platte / September 15, 2024 In 2025, the Special Supplemental Benefits for the Chronically Ill (SSBCI) can be used by healthy members. True False In 2025, Dual Eligible Medicare Beneficiaries have an SEP to enroll in a DSNP every _______? Quarter 6 Months Month AEP In 2025, the Over-the-Counter Items/ Food and Produce Card allowance will NOT rollover to the next month. True False In 2025, a Dual Eligible beneficiary living within our service area can enroll in BCBSAZ Health Choice Pathway even if they are on a different AHCCCS plan. True False Which of the following marketing practices are acceptable? Have a raffle at the Senior Center to obtain names and phone numbers of people to contact during AEP Call a beneficiary who mailed a business reply card asking for more information Cold call beneficiaries on the Do not call registry to inform them of AEP Knock on a beneficiary’s door and leave a flyer with your contact information Members on BCBSAZ Health Choice Pathway HMO DSNP must obtain a referral from their PCP to see an in-network Specialist provider. True False In 2025, Agents can market MAPD plans in Emergency Room waiting rooms, only if the Agent states that they represent all plans in the area and read the TPMO statement. True False During a formal sales event an agent can provide the following to attendees. Pizza Snacks, such as cheese and crackers Steak and eggs Chicken wings with low-fat ranch dressing DA Scope of Appointment (SOA) needs to be signed _______ before an Agent can meet with a beneficiary to discuss Medicare products. 72 Hours 2 Hours 48 Hours 4-8 Hours BCBSAZ Health Choice Pathway is also considered a Chronic Special Needs Plan (CSNP) since SSBCI benefits are offered to all members. True False A BCBSAZ Health Choice Pathway member will not be involuntary disenrolled from the plan if: They move to another county within the BCBSAZ Health Choice Pathway service area. They are no longer eligible for AHCCCS. They become eligible for AHCCCS Long Term Care (ALTCS). They are no longer enrolled Medicare Part B. A member asks an agent if BCBSAZ Health Choice Pathway has an urgent care benefit and if so, what the benefit includes. Where would the member find this information? Provider Directory Over the Counter Catalog Evidence of Coverage Agent Guide Where can BCBSAZ Health Choice Pathway members go to see if a provider is contracted with the plan? Google Annual Notice of Change Evidence of Coverage Provider Directory Mrs. Garcia will turn 65 at the end of March and enrolled in BCBSAZ Health Choice Pathway in February during her Initial Coverage Election Period (ICEP). When will her coverage begin? February 1 March 1 April 1 May 1 A member asks an agent if BCBSAZ Health Choice Pathway covers Ozempic. Where would the member find this information? Evidence of Coverage Over the Counter Catalog Summary of Benefits Formulary In 2025, the BCBSAZ Health Choice Pathway service area will now include Pima County. True False Dual Eligible Medicare beneficiary means that a beneficiary can be enrolled in a Medicare Supplement and a Medicare Advantage plan at the same time. True False All individual sales/marketing and enrollment calls are required by CMS to be recorded. True False The state insurance department would like to investigate a sales agent that they suspect is violating Medicare communication and marketing regulations. BCBSAZ Health Choice Pathway doesn’t need to allow the investigation because the agent is licensed and has followed the guidelines to date. True False Members on BCBSAZ Health Choice Pathway HMO DSNP do not have a copay for their prescriptions if they are enrolled in LIS (Low Income Subsidy) True False ResultsVote
