UHC CERTIFICATION 2 LATEST VERSIONS ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

UHC CERTIFICATION 2 LATEST
VERSIONS 2025-2026 ACTUAL EXAM 200
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |




Downloaded by Great Mind ()

,Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits.
How does she enroll in Original Medicare? - ANS Her enrollment in Medicare Parts A and
B is generally automatic if she meets all eligibility requirements.

Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to
enroll in a Medicare Supplement Insurance Plan? - ANS When a consumer enrolls in a
Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA
Plan.

Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months,
and being any age with ESRD or ALS are each eligibility requirements for which program? -
ANS Original Medicare

Which of the following defines a Medicare Advantage (MA) Plan? (Select 2) - ANS 1. MA
Plans must provide benefits equivalent to Original Medicare, and most plans also offer
additional benefits.

2. MA Plans provide Medicare hospital and medical insurance and often include Medicare
prescription drug coverage.

Which of the following is NOT an eligibility requirement for enrollment in a Medicare Advantage
Plan? - ANS Does not have any pre-existing conditions such as diabetes or End Stage
Renal Disease (ESRD)

Which of the following statements is correct about HMO MA Plans? - ANS Members must
receive covered services from contracted network providers with limited exceptions.

Which of the following is NOT a correct statement about in-network provider services? - ANS
(INCORRECT) Network-based MA plans have a provider network the member can use, and
some plans also cover certain services outside the network.

What is true about Medicare supplement open enrollment? - ANS (INCORRECT) A
consumer who waits to enroll in Medicare Part B until age 66 or older cannot qualify for
Medicare Supplement Open Enrollment.




Downloaded by Great Mind ()

, (INCORRECT) It is the only time a consumer is eligible to purchase a Medicare Supplement Insuran * * * * * * * * * * * * * * *


ce Plan. *




Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what counts tow
* * * * * * * * * * * * * * *


ard the Out-of-Pocket Maximum. Which of the following is accurate? - ANS
* * * * * * * * * * *


The *


Out-of-Pocket Maximum will include her costs toward any Medicare- * * * * * * * *


covered Part A or B services. * * * * *




Which of the following statements is true about a Medicare Supplement Insurance Plan member wh
* * * * * * * * * * * * * *


o wants to enroll in an MA Plan? - ANS
* * * * * * * * *


Medicare Supplement Insurance cannot be used * * * * * *


in conjunction with an MA Plan; therefore, after receiving confirmation of enrollment into the MA Plan
* * * * * * * * * * * * * * *


, the member must cancel their Medicare Supplement Insurance policy according to their carrier's rul
* * * * * * * * * * * * * *


es.

Which of the following best defines Medicare Part D? - ANS
* * * * * * * * * *


It is a government program, o * * * * *


ffered only through a private insurance company or other private company approved by Medicar
* * * * * * * * * * * * *


e, which provides prescription drug coverage.
* * * * *




Which of the following is a fact about Medicare Prescription Drug Plans? - ANS
* * * * * * * * * * * * *


To enroll, * *


member must be in plans service area * * * * * *




What are two options for Medicare consumers to get Part D prescription drug coverage (assuming
* * * * * * * * * * * * * * *


they meet all eligibility requirements)? (Select 2) - ANS
* * Enroll in a stand-
* * * * * * * * *


alone Medicare Prescription Drug Plan (PDP)
* * * * *




Enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug
* * * * * * * * * * * * * * *


coverage

Which of the following statements does NOT correctly define prescription drug stages? -
* * * * * * * * * * * *


ANS A deductible is the amount the member must pay for every prescription medication, regardles
* * * * * * * * * * * * * * *


s of what stage they are in.
* * * * * *




Which of these statements is NOT true about the drug utilization management (UM) rules? - ANS
* * * * * * * * * * * * * * *


(INCORRECT) Prior authorization, quantity limit, and step therapy are some exampl * * * * * * * * * *


es of UM rules * * *




What is the amount added to the member's monthly plan premium if they did NOT enroll in a Medic
* * * * * * * * * * * * * * * * * *


are Advantage plan with Part D benefits or stand-
* * * * * * * *


alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went with
* * * * * * * * * * * * * * * * *


out creditable prescription drug coverage for 63 or more continuous days? - ANS
* * * * * * * * * * * *


Late Enrollment Penalty (LEP) * * *




Downloaded*by*Great*Mind*()