UHC Certification Questions And Answers
Well Illustrated.
Medicare - correct answer. Federal health insurance program
Medicare is administered by whom? - correct answer. CMS ( Centers for medicare
and medicaid services)
Parts A & B of medicare are - correct answer. federal health insurance program
referred to as original medicare
Part A? - correct answer. Hospital insurance
Part B? - correct answer. Medical insurance
What doesnt medicare cover? - correct answer. routine dental, eye care hearing
exam,deductibles, coinsurance and copayments
Part C? - correct answer. Medicare Advantage Plans
MA covers? - correct answer. Part A &B coverage, and some part D coverage
MA plans are not? - correct answer. Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement? - correct answer. MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services? - correct answer. YES
MA plans integrate what type of additonal coverage? - correct answer. part D
prescription drug coverage
If a customer wants to keep their stand alone prescription drug plan, what may the
customer want to enroll in? - correct answer. MA-only PFFS plan
What is a stand alone drug plan called? - correct answer. PDP
WHat is PFFS? - correct answer. Private Fee for Service (PFFS) - Plans that allow
you to go to any doctor or hospital that accepts their terms
, If a customer lives in a rural area, what type of plan may they want because it gives
them freedom to access doctors that may not be in their network? - correct answer.
PFFS plan
Do HMO's require referals? - correct answer. Yes
Do PPO's require a referal? - correct answer. No
When a member enrolls in a MA plan, they receive their coverage from medicare or the
MA plan? - correct answer. MA plan
When a customer is enrolled in a MA plan, they must continue paying their premiums
for what other plan? - correct answer. Part B
MA plans have a maxium annual limit on OOP costs called a? - correct answer.
MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automatically disenrolled from any
other MA plan or PDP( prescription drug plan) in which they are enrolled as of the new
plans_____? - correct answer. effective date
An exception exisits for MA-only PFFS plans as a member can also be enrolled in a
what? - correct answer. Stand alone PDP
If a member enrolls in a MA plan, what must the member do? - correct answer.
Cancel in writing their medicare supplement insurance policy with the carrier after their
request to enroll in MA plan has been approved.
Medicare supplement insurance policies cannot be used in conjunction with what type
of plan? - correct answer. MA plan
A medicare supplement insurance plan helps to cover some of the OOP costs
associated with? - correct answer. original medicare.
A medicare supplement insurance plan does NOT pay the cost-sharing of what type of
plan? - correct answer. MA plan
when a client enrolls in a MA plan, will it automatically terminate their MA plan? - correct
answer. NO
Can a customer call to terminate their Med Sup plan? - correct answer. no it must be
done in writing
What are the different types of MA plans? - correct answer. HMO, POS, PPO, RPPO,
PFFS, SNP, and MSA
Well Illustrated.
Medicare - correct answer. Federal health insurance program
Medicare is administered by whom? - correct answer. CMS ( Centers for medicare
and medicaid services)
Parts A & B of medicare are - correct answer. federal health insurance program
referred to as original medicare
Part A? - correct answer. Hospital insurance
Part B? - correct answer. Medical insurance
What doesnt medicare cover? - correct answer. routine dental, eye care hearing
exam,deductibles, coinsurance and copayments
Part C? - correct answer. Medicare Advantage Plans
MA covers? - correct answer. Part A &B coverage, and some part D coverage
MA plans are not? - correct answer. Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement? - correct answer. MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services? - correct answer. YES
MA plans integrate what type of additonal coverage? - correct answer. part D
prescription drug coverage
If a customer wants to keep their stand alone prescription drug plan, what may the
customer want to enroll in? - correct answer. MA-only PFFS plan
What is a stand alone drug plan called? - correct answer. PDP
WHat is PFFS? - correct answer. Private Fee for Service (PFFS) - Plans that allow
you to go to any doctor or hospital that accepts their terms
, If a customer lives in a rural area, what type of plan may they want because it gives
them freedom to access doctors that may not be in their network? - correct answer.
PFFS plan
Do HMO's require referals? - correct answer. Yes
Do PPO's require a referal? - correct answer. No
When a member enrolls in a MA plan, they receive their coverage from medicare or the
MA plan? - correct answer. MA plan
When a customer is enrolled in a MA plan, they must continue paying their premiums
for what other plan? - correct answer. Part B
MA plans have a maxium annual limit on OOP costs called a? - correct answer.
MOOP amount ( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automatically disenrolled from any
other MA plan or PDP( prescription drug plan) in which they are enrolled as of the new
plans_____? - correct answer. effective date
An exception exisits for MA-only PFFS plans as a member can also be enrolled in a
what? - correct answer. Stand alone PDP
If a member enrolls in a MA plan, what must the member do? - correct answer.
Cancel in writing their medicare supplement insurance policy with the carrier after their
request to enroll in MA plan has been approved.
Medicare supplement insurance policies cannot be used in conjunction with what type
of plan? - correct answer. MA plan
A medicare supplement insurance plan helps to cover some of the OOP costs
associated with? - correct answer. original medicare.
A medicare supplement insurance plan does NOT pay the cost-sharing of what type of
plan? - correct answer. MA plan
when a client enrolls in a MA plan, will it automatically terminate their MA plan? - correct
answer. NO
Can a customer call to terminate their Med Sup plan? - correct answer. no it must be
done in writing
What are the different types of MA plans? - correct answer. HMO, POS, PPO, RPPO,
PFFS, SNP, and MSA
