UHC Medicare Basics Assessment Test With Guaranteed Answers A+ Score.

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? - correct answer 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? - correct answer The consumer must be in a valid MA election or disenrollment period. Provided other eligibility requirements are met, who is eligible for Medicare? - correct answer 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) - correct answer -An MA Plan is a health plan option approved by Medicare and offered by private insurance companies. -An MA Plan is part of Medicare and is also called Part C. -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? - correct answer Medicare Advantage Which of the following statements is correct about HMO MA Plans? - correct answer 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? - correct answer HMO, POS, PPO When does Medicare Supplement Open Enrollment take place? - correct answer 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? - correct answer 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? - correct answer 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? - correct answer 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? - correct answer 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? - correct answer A stand-alone Part D Plan. Which of the following statements accurately describes a prescription drug stage? - correct answer 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? - correct answer 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 ______________. - correct answer 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? - correct answer Through subsidies such as lower or no monthly plan premiums and lower or no copayments. Which of the following is a characteristic of a drug tier? - correct answer All of the drugs in the tier have the same copayment or coinsurance. Which of the following is true about Medicare Supplement Insurance underwriting criteria in states where underwriting applies? - correct answer Underwriting is required if the consumer is not in their Medicare Supplement Open Enrollment period or does not meet Guaranteed Issue