2025 Devoted Health Medicare Certification ExamBy Brian Platte / August 7, 2024 Luis lives in Phoenix and receives full subsidy low income subsidy (LIS). He is reviewing Devoted’s MAPD options with his agent, Wayne. Which statement is most appropriate for Wayne to make regarding Luis’ options? Because Luis receives the full low-income subsidy (LIS) from SSA or the Federal government, he would not be subject to paying the premium on the Devoted Health Premium plan, and may suit his needs best. The Devoted HMO Select/Prime plan is only for full dual eligibles - people who have both Medicare A&B and Medicaid, so Luis would only be eligible if he had full Medicaid benefits. The Devoted HMO Premium plan has a monthly premium; it will cost Luis more than choosing other options. The Devoted Health's Select/Prime/Premium plans are plans that expedites the shipping of prescription medications to Luis’ house for the price of a higher monthly premium. In what situation is an agent representing Devoted Health required to review the entire summary of benefits during a compliant sales presentation to a prospect? Only if the the prospect has additional questions after the Sales Agent reviewed the Benefits-at-a-Glance. Only during seminar presentations but not during one-on-one presentations. Only when the prospects requests it to be reviewed in its entirety. On every sales presentation. How many days in advance must agents register informal or educational events with Devoted Health? 30 days 14 days 7 days 3 days Which answer best describes our main component(s) of our model of care? Care coordination Provider network Quality of performance and improvement Population description All of these Which of the following is not a required part of the Devoted Health sales presentation Conduct a needs analysis to determine which plan might fit an individuals needs Review the provider network and if applicable formulary Review the summary of benefits, Devoted video/presentation and star ratings Request the beneficiary's latest physical exam report True or False - Many of Devoted Health PPO plans have a passive design meaning the in and out of network copays for most services are the same. True False Which answer best describes the options an agent has for completing a scope of appointment (SOA) with Devoted Health All of these are available options Electronic In-person Electronic Remote Text or Email Paper Telephonic Which answer best describes what is important to review with a prospect during our sales presentations related to prescriptions Review the pharmacy network requirement and where individuals can find which pharmacies are in-network. Review the transition supply process and the process for exceptions. Review M3P Explain limitations associated with obtaining prescriptions including Prior Authorization, Step Therapy, and Quantity Limits. Offer to look up their prescriptions and show them how they can look up their prescriptions to see if they are covered by the plan. All of these Review the different stages of prescription coverage True or False - Completing an HRA is not a required part of the enrollment process, but it is highly encouraged as it can help identify important programs available to the member. True False Devoted Health’s value proposition is to… Help simplify its members’ healthcare experience. All of these are a part of Devoted Health's value proposition Provide all in one healthcare Treat every member like it would for its own family member. True or False - A Devoted Health HMO or PPO MA only member may also have a stand alone prescription drug plan True False Mr. Finn, an agent with Devoted Health, is giving a sales presentation and wants to provide some food for his guests. What can Mr. Finn provide? Lunch at a restaurant but ordering off of a limited menu so as to keep the overall cost of the meal below $10 per person. A sit down meal offered in a separate room, before or after the promotional portion of the event. Light refreshments or snacks. A buffet dinner as long as the cost is not above $15 per person. What can Devoted Health members expect after enrollment? All of these can be expected for all new Devoted Health members after enrollment Welcome kit with ID card and a mailed evidence of coverage. Welcome text message, if the individual has transition needs a welcome call and a welcome kit with a benefit guide. The ID card will be mailed separate. Welcome call, welcome Kit with ID card and mailed full directory and formulary. Devoted Health HMO members... Can choose a specialist to be their primary care physician. Must choose an in-network primary care physician at the time of enrollment. Can choose a non-participating doctor as their primary care physician. Can never change their primary care physician once they have chosen one. What are the different plan options offered by Devoted Health? C-SNP, D-SNP, PPO, PFFS PPO, PDPs HMO, PPO, DSNP, CSNP, HMO MA-only, PPO MA-only HMO, PPO, DSNP, Medicare Supplements Mrs. Davis is a Devoted Health HMO member and on March 21st calls Angie her Devoted sales agent stating that she wants to switch her primary care physician (PCP). What can Angie tell Mrs. Davis? That she must first get a letter signed by her current PCP agreeing for her to switch and then a second letter from the new PCP who she wants to see in order for Devoted to approve the change That Devoted never allows members to change PCPs. She can call her Devoted Guide Team and they would be happy to assist her in choosing a new one to be effective the beginning of April. That she can only change her PCP during the annual enrollment period and will have to wait until then to do so. What are Devoted Health's core ingredients? Tech platform, available in all 50 states , strong provider partnerships, PPO, Devoted Guides Newer MA plan, tech platform, strong provider partnerships, Devoted Guides, Devoted Medical Group Newer MA plan, CSNP, strong PCP partnerships, Devoted Guides, Devoted Medical Group Tech platform, available in all 50 states, strong provider partnerships, Med Supp, Devoted Guides Which answer best describes the eligibility requirements for an individual to enroll a Devoted Health Medicare Advantage plan? Eligible for Part A and enrolled in Part B as of the plan start date, have a qualifying election period, not have ESRD Live in the plan service area, have a qualifying election period, have Medicaid Eligible for Part A and enrolled in Part B as of the plan start date, have a qualifying election period, have all doctors in the plans network Live in the plan service area, eligible for Part A and enrolled in Part B as of the plan start date, have a qualifying election period and if a SNP they must have the special need associated with the plan The Devoted Health Guides... Are only available to Devoted Health special needs plan members. Do not attempt to build long lasting relationships built on trust and guidance with Devoted members. Consist of a team of clinical and service professionals who work together for each of our members. Act as travel agents to plan vacations for Devoted members. Which answer best describes the information that is important to share with a beneficiary when enrolling them in a Giveback plan As a result of receiving money back for their Part B premium, members will have higher cost sharing and fewer additional benefits than those offered on the other Devoted Health plans. It may take up to 3 months for an individual’s Part B reduction to show up in their social security check. Payments will be retroactive for the months that were missed. If the individual is not paying their Part B premium because it is paid for by medicaid the Giveback plan is not the right plan for them as they will not get the money back A giveback will increase the value of a member’s monthly social security check, since they are not paying as much for their Part B. If an individual is not receiving a social security check, they will see a reduction in the amount they owe monthly for their Medicare Part B. There are still some additional supplemental benefits associated with the plan All of these are important to inform the beneficiary about ResultsVote
