UHC CERTIFICATION ACTUAL
EXAM PAPER QUESTIONS WITH
COMPLETE SOLUTIONS GRADED A
PLUS
⩥ 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
⩥ 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
⩥ 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
⩥ 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
⩥ An exception exisits for MA-only PFFS plans as a member can also
be enrolled in a what?. Answer: Stand alone PDP
⩥ If a member enrolls in a MA plan, what must the member do?.
Answer: Cancel in writing their medicare supplement insurance policy
with the carrier after their request to enroll in MA plan has been
approved.
EXAM PAPER QUESTIONS WITH
COMPLETE SOLUTIONS GRADED A
PLUS
⩥ 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
⩥ 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
⩥ 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
⩥ 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
⩥ An exception exisits for MA-only PFFS plans as a member can also
be enrolled in a what?. Answer: Stand alone PDP
⩥ If a member enrolls in a MA plan, what must the member do?.
Answer: Cancel in writing their medicare supplement insurance policy
with the carrier after their request to enroll in MA plan has been
approved.
