UHC Certification Questions And Answers
Rated A+.
Joseph has Original Medicare and was a patient in the hospital last week. What part of
Medicare helps cover the costs of his inpatient hospital stay? - correct answer. Part A
- correct answer. The consumer must be in a valid MA election or disenrollment
period.
Which of the following consumers would be eligible for Medicare? - correct answer.
Consumers age 65 or older, consumers under 65 years of age with certain disabilities
for more than 24 months and consumers of all ages with ESRD or ALS
Which of the following defines a Medicare Advantage (MA) Plan? - correct answer.
MA Plans are health plan options approved by Medicare and offered by private
insurance companies.
Janice wants to enroll in a 2021 Medicare Advantage plan. What eligibility requirements
must she meet? (Select the two answers that apply.) - correct answer. Not have End
Stage Renal Disease (permanent kidney failure)Reside in the plan's service area
What must be explained to consumers enrolling in an HMO (Health Maintenance
Organization) MA Plan? (Select 3) - correct answer.
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
Which is true about Medicare Supplement Open Enrollment? - correct answer. By
federal law, Medicare Supplement Open Enrollment is the first 6 months a consumer is
65 or older and enrolled in Medicare Part B.
How does the Medicare Advantage Out-of-Pocket (OOP) maximum work? - correct
answer. The OOP maximum is a feature that limits the amount of money a consumer
will have to spend on Medicare-covered health care services each year.
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
A government program, offered only through a private insurance company or other
private company approved by Medicare, that provides prescription drug coverage
describes which of the following: - correct answer. Medicare Parts A and B
Which of the following statements is true about eligibility requirements for Medicare
Prescription Drug Plans? - correct answer. A consumer must be entitled to Medicare
Part A and/or enrolled in Medicare Part B
What are two options for Medicare consumers to get Part D prescription drug coverage
(assuming they meet all eligibility requirements)? (Select 2) - correct answer.
Which of the following statements is not true about the Coverage Gap? - correct
answer. All members reach the Coverage Gap
Which of the following options are drug utilization management (UM) rules? (Select 3) -
correct answer.
Which of the following best describes the Late Enrollment Penalty (LEP)? - correct
answer. The amount added to the member's monthly plan premium 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 continuous days or more.
Through which means is financial assistance offered to a consumer who qualifies for
Low Income Subsidy 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
Medications that are covered in a Plan's formulary have various levels of associated
member cost-sharing (copayments or coinsurance). What are these drug levels called?
- correct answer. Drug tiers
In states where Medicare Supplement Insurance underwriting criteria can apply, all of
the following underwriting criteria apply EXCEPT: - correct answer. Consumers may
be underwritten to determine their acceptance and, if applicable, their rate.
The new MACRA legislation, which went into effect January 1, 2020, applies to all
carriers offering Medicare supplement plans. - correct answer. TRUE
Which of the following is NOT true of Medicare Supplement Insurance Plans? - correct
answer. Plan benefit amounts automatically update when Medicare changes cost
sharing amounts, such as deductibles, coinsurance and copayments. NOT
Rated A+.
Joseph has Original Medicare and was a patient in the hospital last week. What part of
Medicare helps cover the costs of his inpatient hospital stay? - correct answer. Part A
- correct answer. The consumer must be in a valid MA election or disenrollment
period.
Which of the following consumers would be eligible for Medicare? - correct answer.
Consumers age 65 or older, consumers under 65 years of age with certain disabilities
for more than 24 months and consumers of all ages with ESRD or ALS
Which of the following defines a Medicare Advantage (MA) Plan? - correct answer.
MA Plans are health plan options approved by Medicare and offered by private
insurance companies.
Janice wants to enroll in a 2021 Medicare Advantage plan. What eligibility requirements
must she meet? (Select the two answers that apply.) - correct answer. Not have End
Stage Renal Disease (permanent kidney failure)Reside in the plan's service area
What must be explained to consumers enrolling in an HMO (Health Maintenance
Organization) MA Plan? (Select 3) - correct answer.
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
Which is true about Medicare Supplement Open Enrollment? - correct answer. By
federal law, Medicare Supplement Open Enrollment is the first 6 months a consumer is
65 or older and enrolled in Medicare Part B.
How does the Medicare Advantage Out-of-Pocket (OOP) maximum work? - correct
answer. The OOP maximum is a feature that limits the amount of money a consumer
will have to spend on Medicare-covered health care services each year.
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
A government program, offered only through a private insurance company or other
private company approved by Medicare, that provides prescription drug coverage
describes which of the following: - correct answer. Medicare Parts A and B
Which of the following statements is true about eligibility requirements for Medicare
Prescription Drug Plans? - correct answer. A consumer must be entitled to Medicare
Part A and/or enrolled in Medicare Part B
What are two options for Medicare consumers to get Part D prescription drug coverage
(assuming they meet all eligibility requirements)? (Select 2) - correct answer.
Which of the following statements is not true about the Coverage Gap? - correct
answer. All members reach the Coverage Gap
Which of the following options are drug utilization management (UM) rules? (Select 3) -
correct answer.
Which of the following best describes the Late Enrollment Penalty (LEP)? - correct
answer. The amount added to the member's monthly plan premium 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 continuous days or more.
Through which means is financial assistance offered to a consumer who qualifies for
Low Income Subsidy 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
Medications that are covered in a Plan's formulary have various levels of associated
member cost-sharing (copayments or coinsurance). What are these drug levels called?
- correct answer. Drug tiers
In states where Medicare Supplement Insurance underwriting criteria can apply, all of
the following underwriting criteria apply EXCEPT: - correct answer. Consumers may
be underwritten to determine their acceptance and, if applicable, their rate.
The new MACRA legislation, which went into effect January 1, 2020, applies to all
carriers offering Medicare supplement plans. - correct answer. TRUE
Which of the following is NOT true of Medicare Supplement Insurance Plans? - correct
answer. Plan benefit amounts automatically update when Medicare changes cost
sharing amounts, such as deductibles, coinsurance and copayments. NOT
