1. Do UCare for Seniors members have coverage when they are traveling? *
	A. No, there is no coverage out of the service area. B. Yes, they have world-wide emergency care, urgent care, and Point of Service coverage for non-emergencies within the US. C. Yes, but only world-wide emergency and urgent care. D. Yes, but all out of network care must be paid for and submitted to Medicare for reimbursement.
2. What is the coverage for Medicare Part B drugs for all UCare for Seniors plans? *
	A. Chemotherapy covered at $75/visit; all other Part B drugs covered at 20% coinsurance. B. Chemotherapy covered at $75/visit; all other Part B drugs covered at 10% coinsurance. C. All Part B drugs are covered at the standard Medicare benefit of 20% coinsurance. D. Part B drugs are covered with a $10 copay for generics, $25 copy for brand drugs.
3. There is no deductible on the prescription drug coverage included in both the Essentials Rx and the Classic plan options. *
	A. True B. False
4. What type of prescriptions can be filled through the mail order program? *
	A. Over-the-counter prescriptions. B. Drugs for weight loss/gain. C. Maintenance drugs.
5. What type of plan is UCare for Seniors? *
	A. A Basic Medicare Supplement B. A Medicare Advantage Point-of-Service Plan C. A Medicare Advantage PPO Plan D. A Medicare Cost Plan
6. What are the options to pay for UCare for Seniors? *
	A. By check with monthly billing. B. By automatic payment from a checking or savings account. C. By Social Security check withdrawal. D. All of the above.
7. All UCare for Seniors plans waive the three day hospital stay requirement for coverage in a skilled nursing facility. *
	A. True B. False
8. What is the copay for each plan for primary care office visits? *
	A. Value/Value Plus = $25; Classic = $0; Essentials Rx = $15 B. Value/Value Plus = $25; Classic = $10; Essentials Rx = $40 C. Value/Value Plus = $0; Classic = $0; Essentials Rx = $15 D. Value/Value Plus = $30; Classic = $15; Essentials Rx = $0
9. What is the copay for each plan for outpatient hospital diagnostic tests, X-rays and radiology services? *
	A. Value/Value Plus = 10%; Classic = $0; Essentials Rx = 10% B. Value/Value Plus = $25; Classic = $10; Essentials Rx = $35 C. Value/Value Plus = $0; Classic = $0; Essentials Rx = 10%
10. What is the copay for each plan for ambulance services? *
	A. Value/Value Plus = $100; Classic = $50; Essentials Rx = $50 B. Value/Value Plus = $250; Classic = $100; Essentials Rx = $200 C. Value/Value Plus = $100; Classic = $100; Essentials Rx = $200
11. What is the copay for each plan for inpatient hospital care? *
	A. Value/Value Plus = $100; Classic = $50; Essentials Rx = $0/day B. Value/Value Plus = $400; Classic = $200; Essentials Rx = $300/day C. Value/Value Plus = $250; Classic = $100; Essentials Rx = 10%/day
12. What is the coverage for diabetic glucose monitors, test strips and lancets under the Value, Value Plus, and Classic Plans? *
	A. 50% covered B. 80% covered C. 100% covered
13. What is the copay for all UCare for Seniors plans for a covered stay in a skilled nursing facility/hospital swing bed? *
	A. Days 1-100 covered in full on all plans B. Days 1-20 at 100%; $100 copay per day for days 21-100 C. $75 copay days 1-10; no copay days 11-100 D. $40 copay days 1-20; no copay days 21-100
14. Is there any dental coverage included on UCare plans? *
	A. No, UCare plans do not include dental coverage. B. Yes, the Essentials Rx plan includes preventive dental and there is an optional comprehensive dental rider available. C. Yes, all UCare plans include a preventive dental benefit.
15. Does a Medicare beneficiary lose Medicare when they join the UCare for Seniors Plan? *
	A. Yes and no; they lose Medicare Part A, but not Medicare Part B. B. Yes, they lose both Medicare Part A and Part B. C. No, they must have Medicare Part A and B to join. D. No, UCare for Seniors coordinates payments with traditional Medicare.
16. What is the dental coverage on UCare for Seniors Essentials Rx? *
	A. One check up, one cleaning, one filling per member per year. B. Two check ups, three cleanings per year. C. There is no dental coverage on Essentials Rx.
17. UCare for Seniors members with dental coverage: *
	A. Can see any dentist but will first be subject to a $500 deductible. B. Can see any dentist but may be subject to additional out of pocket costs if the dentist they see charges more than the contracted rate for in-network dentists. C. Must receive all services from in-network, contracted dentists.
18. What is the out-of-pocket maximum for all Medicare covered service provided by UCare for Seniors plan options (excluding Medicare Part D) for the 2016 plan year? *
	A. $1,000/year B. $1,500/year C. $3,400/year D. $6,000/year
19. What is the only difference between the prescription drug coverage included in Value Plus as compared to Classic? *
	A. The generic copay for Value Plus is $10 and for Classic only $5. B. The coverage gap is larger for Value Plus. C. There is no upfront deductible for Value Plus. D. The Classic Plan includes copays for generic drug coverage in the coverage gap for Tier 1 and Tier 2 generics.
20. UCare for Seniors members: *
	A. May purchase their health coverage from UCare and their prescription drug coverage from any Part D carrier. B. May only purchase a stand-alone Part D plan from another carrier if they are enrolled in the Value plan. C. If they want drug coverage, must purchase Part D with their UCare health plan unless they have creditable coverage from an employer, VA, or State drug plan. D. Are prohibited by law from purchasing a separate, stand-alone Part D plan and the UCare health plan. E. Both C and D.
21. The Primary Care Clinic (PCC) number on the UCare for Seniors application refers to: *
	A. The phone number for the member’s doctor. B. The street address for the member’s clinic. C. The six digit number that identifies the member’s PCC of choice.
22. Which of the following services are excluded from coverage in the Point of Service benefit? *
	A. Organ transplants only. B. Routine dental only. C. Nothing is excluded from Point of Service coverage. D. Chiropractic, organ transplants, routine dental, and outpatient prescription drugs.
23. What is the emergency room copay for all UCare for Seniors benefit designs: *
	A. $50 per visit, waived if admitted to the hospital within 24 hours of visit. B. $75 per visit, waived if admitted to the hospital within 24 hours of visit.
24. What health club options are included with all UCare for Seniors plans? *
	A. SilverSneakers, which offers $20 dues discounts at select health clubs. B. UCare members have access to both SilverSneakers or dues discounts on monthly fees at select health clubs. C. UCare plans do not include health club benefits.
25. Does an applicant need to send money in with the UCare for Seniors enrollment form? *
	A. Yes, they need to send the first month’s payment. B. No, they do not need to send any money.