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Exam (elaborations)

Uhc Events Basics Exam Script Comprehensive Study Guide

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UHC EVENTS BASICS EXAM SCRIPT COMPREHENSIVE STUDY GUIDE

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UHC EVENTS BASICS EXAM SCRIPT
COMPREHENSIVE STUDY GUIDE

●● Which statement is true about a member of a Medicare Advantage
(MA) Plan who wants to enroll in a Medicare Supplement Insurance
Plan?
Answer: 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?
Answer: Original Medicare


●● Which of the following defines a Medicare Advantage (MA) Plan?
(Select 2)
Answer: 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?

,Answer: 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?
Answer: 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?
Answer: (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?
Answer: (INCORRECT) A consumer who waits to enroll in Medicare
Part B until age 66 or older cannot qualify for Medicare Supplement
Open Enrollment.


(INCORRECT) It is the only time a consumer is eligible to purchase a
Medicare Supplement Insurance Plan.


●● Jennifer is enrolling into a Medicare Advantage (MA) plan and
wants to know what counts toward the Out-of-Pocket Maximum. Which
of the following is accurate?

, Answer: 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 who wants to enroll in an MA Plan?
Answer: 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 rules.


●● Which of the following best defines Medicare Part D?
Answer: It is a government program, offered only through a private
insurance company or other private company approved by Medicare,
which provides prescription drug coverage.


●● Which of the following is a fact about Medicare Prescription Drug
Plans?
Answer: 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)
Answer: Enroll in a stand-alone Medicare Prescription Drug Plan (PDP)

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