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UHC Certification Exam Questions and Verified Answers | Medicare Enrollment, Original Medicare Eligibility, Medicare Advantage Part C, HMO, PPO, POS Plans, Medicare Supplement Open Enrollment, Out-of-Pocket Maximums and Part D Drug Coverage | Updated 2026

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Prepare for the UHC UnitedHealthcare Certification Exam with this Medicare-focused study resource featuring exam questions and verified answers on Original Medicare, Medicare Advantage plans, enrollment eligibility, provider networks, Medicare Supplement Insurance, and prescription drug coverage. This resource reviews automatic enrollment in Original Medicare for eligible individuals already receiving Social Security benefits; Medicare eligibility based on age, qualifying disability, End-Stage Renal Disease (ESRD), and Amyotrophic Lateral Sclerosis (ALS); and the relationship between Original Medicare and Medicare Advantage Part C. Explore Medicare Advantage plan requirements, including Part A entitlement, Part B enrollment, residence within the plan's service area, and the requirement for Medicare Advantage plans to provide coverage equivalent to Original Medicare. Understand the differences between Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS) plans, with particular attention to provider networks and out-of-network coverage. The study material also covers the six-month Medicare Supplement Open Enrollment Period, Medicare Advantage medical out-of-pocket maximums, excluded expenses such as plan premiums, and automatic disenrollment from a stand-alone Prescription Drug Plan when a consumer enrolls in a Medicare Advantage plan with integrated Part D coverage. Key topics include: - Original Medicare enrollment and eligibility - Medicare Advantage Part C plan definitions and requirements - HMO, PPO, and POS provider network rules - Medicare Supplement Open Enrollment - Medical annual out-of-pocket maximums - Stand-alone Prescription Drug Plans (PDPs) - Medicare Advantage integrated prescription drug coverage - Medicare enrollment changes and plan compatibility Ideal for UnitedHealthcare certification candidates, Medicare insurance learners, and agents reviewing Medicare coverage rules and enrollment requirements. Updated 2026/2027 | Instant Download

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UHC Cert Exam
Questions Verified
and Provided with
A+ Graded
Answers| Latest
Updated 2026
Milton is retiring on his 65th birthday. He is eligible for Medicare and already gets
Social Security benefits. How does he enroll in Original Medicare?
- He must enroll in Medicare Parts A and B through his current or former employer.
- His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements.
- He can only sign up for Medicare Parts A and/or B at his local Social Security office.
- He can sign up for Medicare Parts A and/or B with any licensed insurance agent.


His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements.

,If a consumer currently has a Medicare Advantage plan and wants a Medicare
Supplement Plan , which statement is correct?
- They can have both plans at the same time for extra coverage.
- Enrolling in a Medicare Supplement Plan automatically cancels their MA plan.
- They must disenroll from the MA plan during a valid election period.
- They can only switch during the Annual Election Period (Oct 15-Dec 7).


They must disenroll from the MA plan during a valid election period.



Being 65 or older, or being under 65 with a qualifying disability, or being any
age with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis
(ALS) are eligibility requirements for which program?
- Medicaid
- Low Income Subsidy
- Original Medicare


Original Medicare

,Which of the following statements describe a Medicare Advantage (MA) plan? (select 3)
- MA plans are offered by private insurance companies and approved and contracted by
the federal government.
- MA plans must provide at least the same coverage as Original Medicare and often
include additional benefits like prescription drug coverage (Part D) and more.
- MA plans are part of Medicare and also referred to as Part C.
- MA plans do NOT have to provide at least the same coverage as Original Medicare.


- MA plans are offered by private insurance companies and approved and contracted by
the federal government.
- MA plans must provide at least the same coverage as Original Medicare and often
include additional benefits like prescription drug coverage (Part D) and more.
- MA plans are part of Medicare and also referred to as Part C.



Which of the following are eligibility requirements to enroll in a Medicare Advantage
plan? (Select 3)
- Is enrolled in Medicare Part B
- Does not have any pre-existing conditions such as diabetes or End Stage Renal
Disease (ESRD)
- Lives in the plan's service area
- Is entitled to Medicare Part A


- Is enrolled in Medicare Part B
- Lives in the plan's service area
- Is entitled to Medicare Part A

, Which of the following is a correct statement about network provider services?
- Point-of-Service (POS) plans must cover the same benefits out-of-network
that they cover in-network.
- Preferred Provider Organization (PPO) plans can chose to cover select benefits
out-of-network.
- Health Maintenance Organization (HMO) plans generally cover only in-
network services. In most cases, members pay the full cost of any out-of-
network services received, with a few important exceptions.


- Health Maintenance Organization (HMO) plans generally cover only in-
network services. In most cases, members pay the full cost of any out-of-
network services received, with a few important exceptions.



Which type of MA plan is an HMO plan that also covers certain benefits out-of-
network, generally at a higher cost?
- Point-of-Service (POS) plan
- Part D plan Medicare Supplement Plan
- Private Fee-for-Service (PFFS)


- Point-of-Service (POS) plan


Which statement correctly describes the Medicare Supplement Open Enrollment
Period?
- It begins 3 months before the consumer's 65th birthday and ends 3 months after.
- It occurs annually during the Medicare Advantage Open Enrollment Period.
- It lasts 3 months and begins when the consumer enrolls in Medicare Part A and B.
- It lasts 6 months and begins when the consumer is 65 or older and enrolled in
Medicare Part B.


- It lasts 6 months and begins when the consumer is 65 or older and enrolled in
Medicare Part B.

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