UHC Final Exam (2026/2027) | Actual Questions and Answers Latest Updated 2026/2027 (Graded A+)

UHC Medicare Basics Assessment Exam (2026/2027) | Actual
Questions and Answers Latest Updated 2026/2027 (Graded A+)

•
In which two parts of Medicare is enrollment generally automatic for eligible consumers who are
receiving Social Security benefits, UNLESS they choose to delay their coverage?
- ✔✔Parts A and B

•
Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a
Medicare Supplement Insurance Plan?
- ✔✔The consumer must be in a valid MA election or disenrollment period.

•
Provided other eligibility requirements are met, who is eligible for Medicare?
- ✔✔Consumers age 65 or older, consumers under 65 years of age with a qualifying
disability and consumers of all ages with ESRD or ALS who are receiving Social Security
Disability Insurance (SSDI) for ALS.

•
Which of the following defines a Medicare Advantage (MA) Plan? (Select 3)
i. - ✔✔-An MA Plan is a health plan option approved by Medicare and offered by private
insurance companies.
ii. -An MA Plan is part of Medicare and is also called Part C.
iii. -An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part
B) and often includes Medicare prescription drug coverage (Part D).

•
To be eligible for this plan type, consumers must meet the following requirements: be entitled to
Medicare Part A and enrolled in Part B, and reside in the plan's service area. Which plan is being
described?
- ✔✔Medicare Advantage

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

•
Which of the following are MA Plans that focus on using network providers to maximize the benefits
and reduce out-of-network expenses?
- ✔✔HMO, POS, PPO

•
When does Medicare Supplement Open Enrollment take place?
- ✔✔During the first six months a consumer is 65 or older and enrolled in Medicare Part B.

, •
What costs count toward the out-of-pocket maximum for Medicare Advantage (MA) Plans?
- ✔✔The Out-of-Pocket Maximum includes costs the member pays for any
Medicare-covered Part A or B services but does not include the cost of any plan premiums.

•
A consumer currently has Original Medicare and is enrolled in a stand-alone Prescription Drug Plan
(PDP). What will happen if the consumer enrolls in an MA Plan that has integrated prescription drug
coverage?
- ✔✔The consumer will be automatically disenrolled from their stand-alone PDP upon
enrollment in the MA Plan that has integrated prescription drug coverage

•
What is Medicare Part D?
- ✔✔A voluntary program, offered by private insurance companies that are contracted with
the federal government, that provides prescription drug coverage for an additional monthly
plan premium.

•
Which consumer is eligible for a stand-alone Medicare Prescription Drug Plan?
- ✔✔Joseph, who is enrolled in Medicare Part A and Medicare Part B and resides in the
plan's service area.

•
A consumer with only Part A residing in the plan's service area can enroll in which plan type to get Part
D coverage?
- ✔✔A stand-alone Part D Plan.

•
Which of the following statements accurately describes a prescription drug stage?
- ✔✔Starting in 2024, the catastrophic coverage stage is when the member will pay nothing
for covered drugs for the remainder of the plan year.

•
Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are
all examples of what?
- ✔✔Utilization Management Rules

•
A consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a Medicare
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 without creditable prescription drug coverage for
______________.
- ✔✔63 or more continuous days

•
How does a consumer who qualifies for Low Income Subsidy receive financial assistance for their part
of Medicare Part D costs?