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Earn points by helping other students or get them with a premium plan
KP CERTIFICATION PAPER 2026 FULL SOLUTION GRADED A+
Typology: Exams
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โ Kaiser Permanente Senior Advantage (KPSA) and Medicare Advantage members agree to seek care at Kaiser Permanente or contracted network facilities (except for certain urgent care and emergency-related services).. Answer: True โ Select all that apply: To be eligible for Kaiser Permanente Senior Advantage (KPSA) and Medicare Advantage, an individual must:. Answer: Be a U.S. citizen or lawfully present in the United States Permanently reside in the KP service area Be entitled to Medicare Part A and enrolled in Medicare Part B โ Any KPSA or KPMA member can use the new POS benefit.. Answer: False - Only members enrolled in an HMO-POS plan can utilize the POS benefit โ A member enrolled in the Medicare Explorer plan can use the new POS benefit inside the service area.. Answer: False - Only Care Plus members can use the benefit inside the KP service area. โ To be eligible for the Senior Advantage Special Needs Plan, an individual must already have ____________________.. Answer: Both Medicare and Medicaid
โ AT Kaiser Permanente, _______________ apply to the maximum out - of-pocket (MOOP).. Answer: all Medicare Parts A and B-covered services โ Which of the following is not an advantage of the Kaiser Permanente Medicare Prescription Drug Benefit:. Answer: Elimination of the specialty tier โ What is the tier for non-preferred drugs?. Answer: Tier 4 โ What is the tier for non-preferred generic drugs?. Answer: Tier 2 โ What is the tier for injectable Part D vaccines?. Answer: Tier 6 โ What is the tier for preferred generic drugs?. Answer: Tier 1 โ What is the tier for specialty tier drugs?. Answer: Tier 5 โ What is the tier for preferred brand-name drugs?. Answer: Tier 3 โ Edward is a prospective member who takes generic asthma medication. Which of the tiers below will Edward's prescription most likely fall under?. Answer: Preferred generic drugs
โ To be eligible for Senior Advantage (KPSA) and Medicare Advantage, an individual must:. Answer: Be entitled to Medicare Part A and enrolled in Medicare Part B. โ To be eligible for Senior Advantage (KPSA) and Medicare Advantage, an individual must:. Answer: Permanently reside within the KP Medicare service area. โ Advantage Plus is an optional supplemental plan that _______ at an additional monthly premium.. Answer: Provides extra benefits (such as vision, dental, and/or hearing coverage) โ An HMO-POS plan allows members to use providers outside the plan's network for an additional cost.. Answer: True โ To be eligible for the Senior Advantage Special Needs plan, an individual must already have ___________.. Answer: Both Medicare Part A, Part B, and Medicaid/Medi-Cal. โ Individuals with Medicare and Medicaid or Medi-Cal qualify for a Special Election Period an can enroll or disenroll. Answer: Once per quarter during the first 3 quarters of the year. โ At Kaiser Permanente, _________________ apply to the Maximum Out-of-Pocket (MOOP).. Answer: all Medicare-covered services (Parts A & B)
โ What is the correct prescription drug coverage tier for non-preferred drugs?. Answer: Tier 4 โ What is the correct prescription drug coverage tier for non-preferred generic drugs?. Answer: Tier 2 โ What is the correct prescription drug coverage tier for injectable Part D vaccines?. Answer: Tier 6 โ What is the correct prescription drug coverage tier for preferred generic drugs?. Answer: Tier 1 โ What is the correct prescription drug coverage tier for specialty tier?. Answer: Tier 5 โ What is the correct prescription drug coverage tier for preferred band- name drugs?. Answer: Tier 3 โ Under KPs Medicare prescription drug benefit, when are injectable Part D vaccines covered at no charge?. Answer: At any coverage stage (in most plans)