UHC CERTIFICATION TESTED QUESTIONS
AND COMPLETE SOLUTIONS
◉ MSA?
Answer: Medical savings account
◉ What does a MSA do?
Answer: Combines a high deductible medicare advantage plan and
a bank account
◉ How does MSA plans work?
Answer: the plan deposits money from emdicare in the account
which can then be used to pay for medical expenses until their
deductible is met
◉ Does UHC currently offer a MSA?
Answer: no
◉ MA plans include some key features such as?
Answer: Prescription drug coverage, PCPs and a OOP maxium
◉ In a MA-Part D plan, A member will be disenrolled from their
stand alone PDP upon enrollment in a ?
Answer: MA-PD
,◉ in a MA-part D plan, A member will be disenrolled from their
MA-PD upon enrollment in?
Answer: a stand-alone PDP
◉ With MA only, a member will be disenrolled from their stand
alone PDP upon enrolling in a?
Answer: Non-PFFS MA-only plan
◉ in MA-only, a member will be disenrolled from their non-PFFS
MA-only plan upon enrolling in a?
Answer: Stand alone PDP
◉ most MA plans require a what? although not all plans require
that the chosen____ cordinate the members care
Answer: PCP selection
◉ If a PCP is required and the customer does not indicate one on
the enrollment application, a _____ will automatically assigned
Answer: PCP
◉ To avoid member complaints, encourage customers to select a
____and make sure the _____ is accepting new patients
Answer: PCP
, ◉ In which plan ( HMO/POS) are out of network benefits available
at a higher cost?
Answer: POS
◉ With a PFFS plan, does a PCP need to be selected? and are prior
authorizations or referrals from a PCP required?
Answer: No, NO
◉ once a member with a MAP reaches the maximum OOP
expenses, is there cost sharing for any additional services?
Answer: no
◉ MA plans with an OON component may or may not have an?
Answer: OOP maximum for OON services depending on the plan
◉ All medicare covered ( part A and part B) services count
torward the?
Answer: OOP maxium with MAP's
◉ Services and deatures that do not count toward the maxium
OOP in a MAP include?
Answer: plan premium, part D prescription drugs and any non-
medicare covered services such as eyewear and hearing aids
◉ Is the OOP maximum amount different between MA plans?
AND COMPLETE SOLUTIONS
◉ MSA?
Answer: Medical savings account
◉ What does a MSA do?
Answer: Combines a high deductible medicare advantage plan and
a bank account
◉ How does MSA plans work?
Answer: the plan deposits money from emdicare in the account
which can then be used to pay for medical expenses until their
deductible is met
◉ Does UHC currently offer a MSA?
Answer: no
◉ MA plans include some key features such as?
Answer: Prescription drug coverage, PCPs and a OOP maxium
◉ In a MA-Part D plan, A member will be disenrolled from their
stand alone PDP upon enrollment in a ?
Answer: MA-PD
,◉ in a MA-part D plan, A member will be disenrolled from their
MA-PD upon enrollment in?
Answer: a stand-alone PDP
◉ With MA only, a member will be disenrolled from their stand
alone PDP upon enrolling in a?
Answer: Non-PFFS MA-only plan
◉ in MA-only, a member will be disenrolled from their non-PFFS
MA-only plan upon enrolling in a?
Answer: Stand alone PDP
◉ most MA plans require a what? although not all plans require
that the chosen____ cordinate the members care
Answer: PCP selection
◉ If a PCP is required and the customer does not indicate one on
the enrollment application, a _____ will automatically assigned
Answer: PCP
◉ To avoid member complaints, encourage customers to select a
____and make sure the _____ is accepting new patients
Answer: PCP
, ◉ In which plan ( HMO/POS) are out of network benefits available
at a higher cost?
Answer: POS
◉ With a PFFS plan, does a PCP need to be selected? and are prior
authorizations or referrals from a PCP required?
Answer: No, NO
◉ once a member with a MAP reaches the maximum OOP
expenses, is there cost sharing for any additional services?
Answer: no
◉ MA plans with an OON component may or may not have an?
Answer: OOP maximum for OON services depending on the plan
◉ All medicare covered ( part A and part B) services count
torward the?
Answer: OOP maxium with MAP's
◉ Services and deatures that do not count toward the maxium
OOP in a MAP include?
Answer: plan premium, part D prescription drugs and any non-
medicare covered services such as eyewear and hearing aids
◉ Is the OOP maximum amount different between MA plans?
