https://www.stuvia.com/user/Performance
UHC certification Questions and Answers with Complete
Solutions UPDATED!!!
Medicare - ANSWER Federal health insurance program
Medicare is administered by whom? - ANSWER CMS ( Centers
for medicare and medicaid services)
Parts A & B of medicare are - ANSWER federal health insurance
program referred to as original medicare
Part A? - ANSWER Hospital insurance
Part B? - ANSWER Medical insurance
What doesnt medicare cover? - ANSWER routine dental, eye
care hearing exam,deductibles, coinsurance and copayments
,https://www.stuvia.com/user/Performance
Part C? - ANSWER Medicare Advantage Plans
MA covers? - ANSWER Part A &B coverage, and some part D
coverage
MA plans are not? - ANSWER Medicare supplement insurance
plans
What offers lower monthly premiums MADP or supplement? -
ANSWER 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? - ANSWER YES
,https://www.stuvia.com/user/Performance
MA plans integrate what type of additonal coverage? - ANSWER
part D prescription drug coverage
If a customer wants to keep their stand alone prescription drug
plan, what may the customer want to enroll in? - ANSWER MA-
only PFFS plan
What is a stand alone drug plan called? - ANSWER PDP
WHat is PFFS? - ANSWER 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? - ANSWER PFFS plan
, https://www.stuvia.com/user/Performance
Do HMO's require referals? - ANSWER Yes
Do PPO's require a referal? - ANSWER No
When a member enrolls in a MA plan, they receive their
coverage from medicare or the MA plan? - ANSWER MA plan
When a customer is enrolled in a MA plan, they must continue
paying their premiums for what other plan? - ANSWER Part B
MA plans have a maxium annual limit on OOP costs called a? -
ANSWER MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are
automatically disenrolled from any other MA plan or PDP(
prescription drug plan) in which they are enrolled as of the new
plans_____? - ANSWER effective date
UHC certification Questions and Answers with Complete
Solutions UPDATED!!!
Medicare - ANSWER Federal health insurance program
Medicare is administered by whom? - ANSWER CMS ( Centers
for medicare and medicaid services)
Parts A & B of medicare are - ANSWER federal health insurance
program referred to as original medicare
Part A? - ANSWER Hospital insurance
Part B? - ANSWER Medical insurance
What doesnt medicare cover? - ANSWER routine dental, eye
care hearing exam,deductibles, coinsurance and copayments
,https://www.stuvia.com/user/Performance
Part C? - ANSWER Medicare Advantage Plans
MA covers? - ANSWER Part A &B coverage, and some part D
coverage
MA plans are not? - ANSWER Medicare supplement insurance
plans
What offers lower monthly premiums MADP or supplement? -
ANSWER 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? - ANSWER YES
,https://www.stuvia.com/user/Performance
MA plans integrate what type of additonal coverage? - ANSWER
part D prescription drug coverage
If a customer wants to keep their stand alone prescription drug
plan, what may the customer want to enroll in? - ANSWER MA-
only PFFS plan
What is a stand alone drug plan called? - ANSWER PDP
WHat is PFFS? - ANSWER 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? - ANSWER PFFS plan
, https://www.stuvia.com/user/Performance
Do HMO's require referals? - ANSWER Yes
Do PPO's require a referal? - ANSWER No
When a member enrolls in a MA plan, they receive their
coverage from medicare or the MA plan? - ANSWER MA plan
When a customer is enrolled in a MA plan, they must continue
paying their premiums for what other plan? - ANSWER Part B
MA plans have a maxium annual limit on OOP costs called a? -
ANSWER MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are
automatically disenrolled from any other MA plan or PDP(
prescription drug plan) in which they are enrolled as of the new
plans_____? - ANSWER effective date
