Aetna Individual Core Certification
Questions and Answers Already Passed
What reports are available on Aetna’s Producer World?
A) Your Medicare book of business
B) Month/YTD/Prior year commission report
C) Licensing reports
D) A and B
E) All of the above ✔✔E) All of the above
You will need to successfully complete which requirements to have “ready-to-sell” status with
Aetna Medicare?
A) The Aetna Individual Medicare certification process for the products you intend to sell
B) Have an active contract through the Medicare Producer Contracting site
C) Be licensed and appointed in accordance with state law in states where you intend to sell
D) Pass a background investigation
E) All of the above ✔✔E) All of the above
Any voluntary disenrollment occurring within three months of the membership effective date is
considered a rapid disenrollment, and will result in a chargeback of the full commission paid.
True or False ✔✔True
To report compliance or fraud, waste, and abuse concerns to Aetna you should:
A) Make an anonymous call to Ethics Line
B) Visit Ethics Line on the web
C) Fax the information
D) Email Medicare Compliance
E) A, B and D ✔✔E) A, B and D
Agent Oversight routinely monitors agent performance against CMS and internal standards. We
monitor:
A) Cancellation and rapid disenrollment rates
B) Enrollment application turnaround time
Aetna MA/MAPD/DSNP Mastery Test
Questions and Answers Graded A+
Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a
person to use only network providers?
A) PDP plan
B) HMO plan
C) PPO plan
D) ESRD plan ✔✔B) HMO
Which plan type allows members to see preferred doctors in network, doctors out of network and
does not require referrals to a specialist?
A) PDP plan
B) Cost plan
C) PPO plan
D) HMO plan ✔✔C) PPO
Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they
are called MAPD plans.
True or False ✔✔True
Aetna case management consists of registered nurses, social workers, behavioral health
professionals and pharmacists who help members navigate the health care system and access
services.
True or False ✔✔True
Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum.
True or False ✔✔False
Aetna Medicare Advantage HMO and PPO plans cover routine preventative care including an
annual wellness visit, screening mammograms, and prostate cancer screenings.
True or False ✔✔True
Aetna Questions and Answers 100%
Pass
Broker Services – Reports
What report(s) are available on Aetna Producer World?
a. Your Medicare book of business
b. Monthly Commission Report (Two years of monthly data is available)
c. License reports
d. A and B
e. All of the above ✔✔E. all of the above
Ready To Sell – Agent RTS Requirements
You will need to successfully complete which requirements to be Ready to Sell (RTS) with
Aetna Medicare?
a. Pass the Aetna Individual Medicare certification process for the product(s) you intend to sell
b. Have an active contract with Aetna Medicare through the Medicare Producer contracting site
c. Receive your Ready to Sell (RTS) notice from Aetna
d. All of the above ✔✔D. all of the above
Compensation – Renewal Commission Payments
Any voluntary disenrollment occurring within three (3) months of the membership effective date
is considered a rapid disenrollment and will result in a chargeback of the full commission paid
True
False ✔✔True
Compliance and Agent Oversight – Fraud, Waste and Abuse
To report compliance or fraud, waste, and abuse concerns to Aetna you should:
a. Make an anonymous call to Ethics Line® (1-877-287-2040)
b. Visit Ethics Line® on the web at www.CVSHealth.com/EthicsLine
c. Fax the information to the closest Social Security office
d. Mail your concerns in writing to David Falkowski, CVS Chief Compliance Officer
e. A, B, and D ✔✔E. A,B, and D
Aetna Individual MA/MAPD/DSNP Quiz
with Certified Solutions
Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a
person to use only network providers? (Excluding emergency or urgently needed services)
✔✔HMO plan
Which plan type allows members to see preferred doctors in network, doctors out-of-network,
and does not require referrals to a specialist? ✔✔PPO plan
Most Aetna Medicare Advantage plans are integrated with prescription drug coverage, so they
are called MAPD plans. ✔✔True
Aetna case management consists of registered nurses, social workers, behavioral health
professionals and pharmacists who help members navigate the health care system and access
services. ✔✔True
Aetna Medicare Advantage HMO and PPO plans have no out-of-pocket maximum. ✔✔False
Aetna Individual Core Certification
Mastery Test Questions and Answers
100% Pass
What report(s) are available on Aetna Producer World? ✔✔All of the above
You will need to successfully complete which requirements to be Ready to Sell (RTS) with
Aetna Medicare? ✔✔All of the above
Any voluntary disenrollment occurring within three (3) months of the membership effective date
is considered a rapid disenrollment and will result in a chargeback of the full commission paid.
✔✔True
To report compliance or fraud, waste, and abuse concerns to Aetna you should: ✔✔A, B, and D
Agent Oversight routinely monitors agent performance against CMS and internal standards. We
monitor: ✔✔All of the above
Our Agent Oversight team will implement corrective action when there are CMS infractions and
prohibited tactics. Disciplinary or corrective action may include: ✔✔All of the above
Failure to respond within the required timeframe to Aetna or CMS requests for information may
result in suspension or termination of an agent, broker or producer’s ability to market, sell and
receive commissions. ✔✔True
You can receive commission for any sale that results from an unreported marketing/sales event.
✔✔False
A prohibited marketing activity is: ✔✔All of the above
How long are you required to maintain Scope of Appointment (SOA) documentation? ✔✔10
years
If a beneficiary requests to discuss other products not originally documented on the SOA, you
must document a second SOA for the additional product type before the appointment may
continue. ✔✔True
When obtaining a Scope of Appointment, you may NOT: ✔✔All of the above
Aetna (2022/2023) – Individual
Prescription Drug Plans – Mastery Test
Already Passed
A beneficiary who currently eligible for Medicare Part A who enrolls into Part B, is
______ ✔✔Not granted an additional IEP to enroll into a Part D plan.
Once submitted, who can cancel an enrollment application before the effective date? ✔✔Both A
and C
If submitted after the first month of eligibility, the effective date for enrollments in the Initial
Enrollment Period (IEP) must be the first of the month following the month the enrollment is
submitted. ✔✔True
If the requested premium payment method is Social Security deductions, ______
✔✔The request must be approved by Social Security, so it could take one to three months for
deductions to begin.
Aetna strictly enforces our enrollment procedures. If you receive an Enrollment Process
Exception Notice, your immediate action will be required in order to avoid any disciplinary
actions, which may include___________________. ✔✔All of the Above
The SilverScript agent portal provides a secure method for external agents and administrators to
communicate with SilverScript’s agent support team so _____________________
can be shared safely. ✔✔All of the Above
SilverScript stand-alone prescription drug plans are sponsored by Aetna Medicare Solutions, a
CVS Health company. ✔✔True
Mail-order prescription drug services are not available for SilverScript PDP plans. ✔✔False
The cost estimates displayed on most pricing tools, such as Medicare.gov, SilverScript.com,
AetnaMedicare.com and most third-party websites, will typically reflect__________________
pricing. ✔✔Both A and C
An Electronic Scope of Appointment (eSOA) valid for _. ✔✔14 days
Aetna Questions and Answers
(2022/2023) Graded A+
Aetna offers a variety of Aetna and Coventry Medicare Advantage plan types. Which plan type
requires a person to use only network providers? (excluding emergency or urgently needed
services) ✔✔HMO plan
Which plan type allows members to see preferred doctors out of network and does not require
referrals to a specialist? ✔✔PPO Plan
Most Aetna and Coventry Medicare Advantage plans are integrated with prescription drug
coverage, so they are called MAPD plans. ✔✔True
Aetna and Coventry case Management consists of registered nurses, social workers, behavioral
health professionals and pharmacists who help members navigate the health care system and
access services. ✔✔True
Aetna Medicare Advatage HMO and PPO plans have no out-of-pocket maximum. ✔✔False
Aetna Medicare Advantage HMO and PPO plans cover routine preventive care including an
annual wellness visit, screening mammograms, and prostate cancer screenings. ✔✔True
A member’s cost share at a preferred pharmacy will usually be lower than cost share at a standard
pharmacy. ✔✔True
All MAPD plans have a prescription drug component. ✔✔True
Which of the following are true? ✔✔All of the above.
You can find a quick list of tools on aetnamedicare.com/brokers which includes information
about plans, medications, and doctors. ✔✔True
What is a Dual eligible Special Needs Plan (D-SNP)? ✔✔All of the above
Low Income Subsidy (LIS) is a Mediare finacial program that helps to reduce prescription drug
costs. ✔✔True
AETNA 2023 MEDICARE MASTERY TEST
QUESTIONS AND ANSWERS ALREADY
PASSED
What report(s) are available on Aetna Producer World ✔✔Commission Reports
How long are you required to maintain Scope of Appointment (SOA) documentation? ✔✔2
Years.
When obtaining a Scope of Appointment, you may NOT: ✔✔Market non-health care products,
such as annuities or life insurance (cross selling)
Annual Election Period is from: ✔✔October 1 – December 7
What are the requirements you need to complete in order to be ready to sell? ✔✔Current
producers need to maintain their licenses and meet our requirements
To report compliance or fraud, waste, and abuse concerns to Aetna you should: ✔✔Visit Ethics
Line® on the web at www.CVSHealth.com/EthicsLine.
Agent Oversight routinely monitors agent performance against CMS and internal standards. We
monitor: ✔✔Scope of Appointment (SOA) forms
Our Agent Oversight team will implement corrective action when there are CMS infractions and
prohibited tactics.
Disciplinary or corrective action may include: ✔✔Suspension or probationary period, with or
without commissions
A prohibited marketing activity is: ✔✔Claiming you are recommended or endorsed by CMS
If a beneficiary requests to discuss other products not originally documented on the SOA, you
must document a second SOA for the additional product type before the appointment may
continue ✔✔False
The Permission to Contact form is used by Aetna sales representatives and external agents to
contact beneficiaries and must be completed prior to conducting an outbound call to a Medicare
prospect ✔✔False
Aetna Individual Prescription Drug Plans
— Mastery Test (2022/2023) Already
Passed
A beneficiary who currently eligible for Medicare Part A who enrolls into Part B, is
______ ✔✔Not granted an additional IEP to enroll into a Part D plan.
Once submitted, who can cancel an enrollment application before the effective date? ✔✔Both A
and C
If submitted after the first month of eligibility, the effective date for enrollments in the Initial
Enrollment Period (IEP) must be the first of the month following the month the enrollment is
submitted. ✔✔True
If the requested premium payment method is Social Security deductions, ______
✔✔The request must be approved by Social Security, so it could take one to three months for
deductions to begin.
Aetna strictly enforces our enrollment procedures. If you receive an Enrollment Process
Exception Notice, your immediate action will be required in order to avoid any disciplinary
actions, which may include___________________. ✔✔All of the Above
The SilverScript agent portal provides a secure method for external agents and administrators to
communicate with SilverScript’s agent support team so _____________________
can be shared safely. ✔✔All of the Above
SilverScript stand-alone prescription drug plans are sponsored by Aetna Medicare Solutions, a
CVS Health company. ✔✔True
Mail-order prescription drug services are not available for SilverScript PDP plans. ✔✔False
The cost estimates displayed on most pricing tools, such as Medicare.gov, SilverScript.com,
AetnaMedicare.com and most third-party websites, will typically reflect__________________
pricing. ✔✔Both A and C
An Electronic Scope of Appointment (eSOA) valid for _. ✔✔14 days
Aetna Individual MA/MAPD/DSNP
Mastery Test Questions and Answers
100% Pass
Which of the following is true for Low Income Subsidy? ✔✔All of the above
What is a Special Needs Plan (SNP)? ✔✔All of the above or A type of Medicare Advantage
Prescription Drug (MAPD) coordinated care plan that limits enrollment to people with specific
diseases or characteristics.
Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a
person to use only network providers? (Excluding emergency or urgently needed services)
✔✔HMO
Which are attributes of the Aetna’s Model of Care? ✔✔All of the above
Which plan type allows members to see preferred doctors in network, doctors out-of-network,
and does not require referrals to a specialist? ✔✔PPO
Which of the following statements are true? ✔✔All of the above
Aetna 2023 MA/MAPD/DSNP Already
Passed
Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type requires a
person to use only network providers? (Excluding emergency or urgently needed services)
a.
PDP plan
b.
HMO plan
c.
PPO plan
d.
ESRD plan ✔✔b.
HMO plan
What is a Special Needs Plan (SNP)?
a.A type of Medicare Advantage Prescription Drug (MAPD) coordinated care plan that limits
enrollment to people with specific diseases or characteristics.
b.An MA plan that tailors benefits, provider choices, and drug formularies to meet specific needs
of the groups they serve.
c.An MA plan for those who are eligible for Medicare and Medicaid.
d.A MA plan required to contract with a state Medicaid agency.
e.
All of the above ✔✔e.
All of the above
Which of the following is true for Low Income Subsidy?
a.Beneficiaries pay no more than $3.95 for a covered generic and $9.85 for each brand name
drug
b.There is no coverage gap
c.There is no Late Enrollment Penalty
d.All of the above ✔✔d.All of the above
Which are attributes of the Aetna’s Model of Care?
a.An Interdisciplinary Care Team approach
b.Clinical programs to improve health and well-being
c.Transition of Care Program
d.A and B
Aetna Individual Prescription Drug Plans
Latest 2023 with Certified Solutions
A beneficiary who was previously entitled to Medicare Part A, but not yet Part B, is
______ ✔✔Able to enroll in Part D without Part B coverage.
Once submitted, who can cancel an enrollment application before the effective date? ✔✔Both A
and C
The effective date for enrollments in the Initial Enrollment Period (IEP) must be the first of the
month following the month of enrollment, beginning with the Part D eligibility date. ✔✔True
If the requested premium payment method is Social Security deductions, ______
✔✔The request must be approved by Social Security, so it could take one to two months for
deductions to begin.
Aetna strictly enforces our enrollment procedures. If you receive an Enrollment Process
Exception Notice, your immediate action will be required in order to avoid any disciplinary
actions, which may include___________________. ✔✔All of the Above
The SilverScript agent portal provides a secure method for external agents and administrators to
communicate with SilverScript’s agent support team so _____________________
can be shared safely. ✔✔All of the Above
Aetna is a CVS Health company that offers SilverScript Part D products. ✔✔True
Mail order prescription drug services are not available for SilverScript PDP plans. ✔✔False
An Electronic Scope of Appointment (eSOA) valid for _. ✔✔14 days
Agents must submit the original documentation for enrollment within 24 hours after the
application data has been entered into the agent portal. ✔✔True
Non‐compliance to the Code of Conduct can affect _______________and may result in legal or
financial consequences. ✔✔All of the above
Agents MUST communicate the pricing tool disclaimer to prospects and clients. The disclaimers
for SilverScript’s Drug Lookup & Pricing tool appear at bottom of the pricing tool pages.
✔✔True
Aetna Prescription Drug Questions and
Answers (Certified and Approved)
Beneficiary who was previously entitled to Medicare Part A, but not yet Part B, is
______ ✔✔Able to enroll in Part D without Part B coverage.
Once submitted, who can cancel an enrollment application before the effective date? ✔✔The
client
The client’s Legal Authorized Representative/POA
The effective date for enrollments in the Initial Enrollment Period (IEP) must be the first of the
month following the month of enrollment, beginning with the Part D eligibility date. ✔✔True
Aetna strictly enforces our enrollment procedures. If you receive an Enrollment Process
Exception Notice, your immediate action will be required in order to avoid any disciplinary
actions, which may include___________________. ✔✔Forfeited commissions
Suspension of your contract
Termination of your contract
The SilverScript agent portal provides a secure method for external agents and administrators to
communicate with SilverScript’s agent support team so _____________________
can be shared safely. ✔✔Medicare numbers
Member ID numbers
Member demographics/personal identifying information
Aetna is a CVS Health company that offers SilverScript Part D products. ✔✔True
The cost estimates displayed on most pricing tools, such as Medicare.gov, SilverScript.com,
AetnaMedicare.com and most third-party websites, will typically reflect__________________
pricing. ✔✔Retail
Mail order
An Electronic Scope of Appointment (eSOA) valid for _. ✔✔14 days
Agents must submit the original documentation for enrollment within 24 hours after the
application data has been entered into the agent portal. ✔✔True
Individual Prescription Drug Plans –
Mastery Test 2023 Already Passed
Once submitted, who can cancel an enrollment application before the effective date? ✔✔The
client
An Electronic Scope of Appointment (eSOA) valid for . ✔✔14 days
If you receive an Enrollment Process Exception Notice, your immediate action will be required
in order to avoid any disciplinary actions, which may include__________________. ✔✔All of
the above
The cost estimates displayed on most pricing tools, such as Medicare.com, SilverScript.com,
AetnaMedicare.com and most third-party websites, will typically reflect ______
pricing. ✔✔Both A and C
Agents must submit the original documentation for enrollment within 24 hours after the
application data has been entered into the agent portal. ✔✔True
Individual Prescription Drug Plans
(2022/2023) Rated A+
Once submitted, who can cancel an enrollment application before the effective date? ✔✔d. Both
A and C
Marks: 1
Aetna strictly enforces our enrollment procedures. If you receive an Enrollment Process
Exception Notice, your immediate action will be required in order to avoid any disciplinary
actions, which may include___________________. ✔✔d. All of the Above
The effective date for enrollments in the Initial Enrollment Period (IEP) must be the first of the
month following the month of enrollment, beginning with the Part D eligibility date. ✔✔True
The SilverScript agent portal provides a secure method for external agents and administrators to
communicate with SilverScript’s agent support team so _____________________
can be shared safely. ✔✔d. All of the Above
Aetna is a CVS Health company that offers SilverScript Part D products. ✔✔True
Mail order prescription drug services are not available for SilverScript PDP plans. ✔✔False
An Electronic Scope of Appointment (eSOA) valid for _. ✔✔b. 14 days
Agents must submit the original documentation for enrollment within 24 hours after the
application data has been entered into the agent portal. ✔✔True
Non‐compliance to the Code of Conduct can affect _______________and may result in legal or
financial consequences. ✔✔d. All of the above
Agents MUST communicate the pricing tool disclaimer to prospects and clients. The disclaimers
for SilverScript’s Drug Lookup & Pricing tool appear at bottom of the pricing tool pages.
✔✔True
Marks: 1
Before meeting with an applicant, agents must be in good standing with the following: ✔✔e. All
of the above