UHC cer fica on ques on and answers 2026
update
Medicare
Federal health insurance program
Medicare is administered by whom?
CMS ( Centers for medicare and medicaid services)
Parts A & B of medicare are
federal health insurance program referred to as original medicare
Part A?
Hospital insurance
Part B?
Medical insurance
What doesnt medicare cover?
rou$ne dental, eye care hearing exam,deduc$bles, coinsurance and copayments
Part C?
Medicare Advantage Plans
MA covers?
Part A &B coverage, and some part D coverage
MA plans are not?
Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement?
MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services?
YES
MA plans integrate what type of additonal coverage?
, part D prescrip$on drug coverage
If a customer wants to keep their stand alone prescrip$on drug plan, what may the customer
want to enroll in?
MA-only PFFS plan
What is a stand alone drug plan called?
PDP
WHat is PFFS?
Private Fee for Service (PFFS) - Plans that allow you to go to any doctor or hospital that
accepts their terms
If a customer lives in a rural area, what type of plan may they want because it gives them
freedom to access doctors that may not be in their network?
PFFS plan
Do HMO's require referals?
Yes
Do PPO's require a referal?
No
When a member enrolls in a MA plan, they receive their coverage from medicare or the MA
plan?
MA plan
When a customer is enrolled in a MA plan, they must con$nue paying their premiums for
what other plan?
Part B
MA plans have a maxium annual limit on OOP costs called a?
MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automa$cally disenrolled from any other
MA plan or PDP( prescrip$on drug plan) in which they are enrolled as of the new
plans_____?
effec$ve date
An excep$on exisits for MA-only PFFS plans as a member can also be enrolled in a what?
Stand alone PDP
update
Medicare
Federal health insurance program
Medicare is administered by whom?
CMS ( Centers for medicare and medicaid services)
Parts A & B of medicare are
federal health insurance program referred to as original medicare
Part A?
Hospital insurance
Part B?
Medical insurance
What doesnt medicare cover?
rou$ne dental, eye care hearing exam,deduc$bles, coinsurance and copayments
Part C?
Medicare Advantage Plans
MA covers?
Part A &B coverage, and some part D coverage
MA plans are not?
Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement?
MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services?
YES
MA plans integrate what type of additonal coverage?
, part D prescrip$on drug coverage
If a customer wants to keep their stand alone prescrip$on drug plan, what may the customer
want to enroll in?
MA-only PFFS plan
What is a stand alone drug plan called?
PDP
WHat is PFFS?
Private Fee for Service (PFFS) - Plans that allow you to go to any doctor or hospital that
accepts their terms
If a customer lives in a rural area, what type of plan may they want because it gives them
freedom to access doctors that may not be in their network?
PFFS plan
Do HMO's require referals?
Yes
Do PPO's require a referal?
No
When a member enrolls in a MA plan, they receive their coverage from medicare or the MA
plan?
MA plan
When a customer is enrolled in a MA plan, they must con$nue paying their premiums for
what other plan?
Part B
MA plans have a maxium annual limit on OOP costs called a?
MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automa$cally disenrolled from any other
MA plan or PDP( prescrip$on drug plan) in which they are enrolled as of the new
plans_____?
effec$ve date
An excep$on exisits for MA-only PFFS plans as a member can also be enrolled in a what?
Stand alone PDP
