2025 FirstHealth Medicare Certification ExamBy Brian Platte / September 21, 2024 The Healthfirst IBP Plan covers a variety of wellness programs including chiropractic care and Nutritional Counseling. True False The Signature PPO Plan does not include Dental Benefits. True False The 65 Plus plan is designed and available for beneficiaries who are eligible and waiting for their Extra Help, Medicare Savings Program, or Medicaid applications to be approved. True False Which of the following plans is a Special Needs Plan? Increased Benefits Plan Life Improvement Plan Signature HMO Plan Signature PPO (Preferred Provider Organization) Plan Healthfirst Signature HMO and Signature PPO Plans are designed for Medicare beneficiaries who do not qualify for financial assistance. True False In 2025, what is the OTC amount for Life Improvement Plan? $250/month $350/quarter $575/quarter $530/month If a member's circumstances change and they no longer meet the Medicaid eligibility requirements, their membership in Life Improvement Plan (LIP) will end within six months of loss of eligibility unless they regain their eligibility during that time. True False Which of the following plans is preferred for Medicare beneficiaries who qualify for Full Extra Help? Life Improvement Plan Increased Benefits Plan Signature HMO Plan 65 Plus Plan John has Medicaid, Original Medicare Part A & B and a stand-alone prescription drug plan (PDP) with another company. He is a good fit for which plan? Signature HMO Plan Increased Benefits Plan Life Improvement Plan 65 Plus Plan Which of the following plans gives members the freedom to enjoy optional supplemental benefits, called Choice Extras, based on their needs? Life Improvement Plan 65 Plus Plan Increased Benefits Plan Signature HMO Plan Healthfirst Medicare Advantage members cannot visit in-network urgent care centers to get help for non-emergency conditions. True False The Healthfirst Signature HMO plan has a $0 copay for PCP. True False Which of the following plans do not include an OTC card Benefit option? Signature HMO Plan CompleteCare Life Improvement Plan Signature PPO The Healthfirst Signature PPO Plan is NOT available in Orange County or Sullivan County. True False What is the fitness program called covered by Healthfirst Medicare plans? Health and Fitness Reimbursement Program Blink SilverSneakers Planet Fitness The Healthfirst Nurse Help Line is available at no cost to Healthfirst Medicare Advantage plan members seeking answers to health-related questions. True False The Healthfirst Signature PPO plan has an in-network benefit in which other State? Florida Texas New Jersey Connecticut All Healthfirst Medicare Advantage plans include acupuncture benefits. True False The Healthfirst Signature HMO Plan requires referrals for Specialist visits. True False Healthfirst Medicare Advantage plan members must have a referral to see a specialist such as a urologist, cardiologist or dermatologist. False: They can go directly to an in-network specialist without going to a PCP for a referral True: They would need to first go to their PCP (Primary Care Physician) to receive a referral The Healthfirst Signature HMO Plan and Signature PPO Plan have the same provider network. True False Which of the following counties is NOT part of the 65 Plus Plan service area in 2025? Bronx Queens New York Suffolk Which Healthfirst plan is not commissionable to brokers? Signature HMO Plan Life Improvement Plan CompleteCare Increased Benefits Plan Which of the following items is not eligible to be paid for by the Healthfirst OTC card? Pet supplies Home utilities such as gas, oil, water electric, and internet service Healthy foods Over the counter medications and health related items at participating providers Members do not need to continue paying their Part B Premium while they are enrolled in the Healthfirst Signature HMO Plan. True: Enrollment in this plan waives the obligation to pay Part B premiums False: Beneficiaries must still pay their Part B premiums, which are usually taken directly out of their social security checks. ResultsVote
