UHC CERTIFICATION 2 LATEST VERSIONS 2024-2025 ACTUAL EXAM 2
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |
Study online at https://quizlet.com/_fvb6rv
1. Her enrollment in Medicare Parts A and B is gen- Lisa turned 65 and
erally automatic if she meets all eligibility require- is now eligible for
ments. Medicare. She al-
ready receives So-
cial Security benefits.
How does she enroll
in Original Medicare?
2. When a consumer enrolls in a Medicare Supple- Which statement is
ment Insurance Plan, they are not automatically true about a mem-
disenrolled from their MA Plan. ber of a Medicare
Advantage (MA) Plan
who wants to enroll
in a Medicare Supple-
ment Insurance Plan?
3. Original Medicare Being 65 or older, be-
ing under 65 years of
age with certain dis-
abilities for more than
24 months, and being
any age with ESRD
or ALS are each eligi-
bility requirements for
which program?
4. 1. MA Plans must provide benefits equivalent to Which of the fol-
Original Medicare, and most plans also offer addi- lowing defines a
tional benefits. Medicare Advantage
(MA) Plan? (Select 2)
2. MA Plans provide Medicare hospital and medical
insurance and often include Medicare prescription
drug coverage.
5. Does not have any pre-existing conditions such as Which of the fol-
diabetes or End Stage Renal Disease (ESRD) lowing is NOT an
eligibility requirement
for enrollment in a
, UHC CERTIFICATION 2 LATEST VERSIONS 2024-2025 ACTUAL EXAM 2
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |
Study online at https://quizlet.com/_fvb6rv
Medicare Advantage
Plan?
6. Members must receive covered services from con- Which of the follow-
tracted network providers with limited exceptions. ing statements is cor-
rect about HMO MA
Plans?
7. (INCORRECT) Network-based MA plans have a Which of the follow-
provider network the member can use, and some ing is NOT a cor-
plans also cover certain services outside the net- rect statement about
work. in-network provider
services?
8. (INCORRECT) A consumer who waits to enroll in What is true about
Medicare Part B until age 66 or older cannot qualify Medicare supplement
for Medicare Supplement Open Enrollment. open enrollment?
(INCORRECT) It is the only time a consumer is eligi-
ble to purchase a Medicare Supplement Insurance
Plan.
9. The Out-of-Pocket Maximum will include her costs Jennifer is enrolling
toward any Medicare-covered Part A or B services. into a Medicare Ad-
vantage (MA) plan
and wants to know
what counts to-
ward the Out-of-Pock-
et Maximum. Which of
the following is accu-
rate?
10. Medicare Supplement Insurance cannot be used Which of the fol-
in conjunction with an MA Plan; therefore, after lowing statements is
receiving confirmation of enrollment into the MA true about a Medicare
Plan, the member must cancel their Medicare Sup- Supplement Insur-
plement Insurance policy according to their carri- ance Plan member
er's rules.
, UHC CERTIFICATION 2 LATEST VERSIONS 2024-2025 ACTUAL EXAM 2
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |
Study online at https://quizlet.com/_fvb6rv
who wants to enroll in
an MA Plan?
11. It is a government program, offered only through a Which of the fol-
private insurance company or other private compa- lowing best defines
ny approved by Medicare, which provides prescrip- Medicare Part D?
tion drug coverage.
12. To enroll, member must be in plans service area Which of the fol-
lowing is a fact
about Medicare Pre-
scription Drug Plans?
13. Enroll in a stand-alone Medicare Prescription Drug What are two op-
Plan (PDP) tions for Medicare
consumers to get Part
Enroll in a Medicare Advantage Plan or other D prescription drug
Medicare health plan that includes prescription coverage (assuming
drug coverage they meet all eligi-
bility requirements)?
(Select 2)
14. A deductible is the amount the member must pay Which of the follow-
for every prescription medication, regardless of ing statements does
what stage they are in. NOT correctly de-
fine prescription drug
stages?
15. (INCORRECT) Prior authorization, quantity limit, Which of these state-
and step therapy are some examples of UM rules ments is NOT true
about the drug uti-
lization management
(UM) rules?
16. Late Enrollment Penalty (LEP) What is the amount
added to the mem-
ber's monthly plan
premium if they did
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |
Study online at https://quizlet.com/_fvb6rv
1. Her enrollment in Medicare Parts A and B is gen- Lisa turned 65 and
erally automatic if she meets all eligibility require- is now eligible for
ments. Medicare. She al-
ready receives So-
cial Security benefits.
How does she enroll
in Original Medicare?
2. When a consumer enrolls in a Medicare Supple- Which statement is
ment Insurance Plan, they are not automatically true about a mem-
disenrolled from their MA Plan. ber of a Medicare
Advantage (MA) Plan
who wants to enroll
in a Medicare Supple-
ment Insurance Plan?
3. Original Medicare Being 65 or older, be-
ing under 65 years of
age with certain dis-
abilities for more than
24 months, and being
any age with ESRD
or ALS are each eligi-
bility requirements for
which program?
4. 1. MA Plans must provide benefits equivalent to Which of the fol-
Original Medicare, and most plans also offer addi- lowing defines a
tional benefits. Medicare Advantage
(MA) Plan? (Select 2)
2. MA Plans provide Medicare hospital and medical
insurance and often include Medicare prescription
drug coverage.
5. Does not have any pre-existing conditions such as Which of the fol-
diabetes or End Stage Renal Disease (ESRD) lowing is NOT an
eligibility requirement
for enrollment in a
, UHC CERTIFICATION 2 LATEST VERSIONS 2024-2025 ACTUAL EXAM 2
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |
Study online at https://quizlet.com/_fvb6rv
Medicare Advantage
Plan?
6. Members must receive covered services from con- Which of the follow-
tracted network providers with limited exceptions. ing statements is cor-
rect about HMO MA
Plans?
7. (INCORRECT) Network-based MA plans have a Which of the follow-
provider network the member can use, and some ing is NOT a cor-
plans also cover certain services outside the net- rect statement about
work. in-network provider
services?
8. (INCORRECT) A consumer who waits to enroll in What is true about
Medicare Part B until age 66 or older cannot qualify Medicare supplement
for Medicare Supplement Open Enrollment. open enrollment?
(INCORRECT) It is the only time a consumer is eligi-
ble to purchase a Medicare Supplement Insurance
Plan.
9. The Out-of-Pocket Maximum will include her costs Jennifer is enrolling
toward any Medicare-covered Part A or B services. into a Medicare Ad-
vantage (MA) plan
and wants to know
what counts to-
ward the Out-of-Pock-
et Maximum. Which of
the following is accu-
rate?
10. Medicare Supplement Insurance cannot be used Which of the fol-
in conjunction with an MA Plan; therefore, after lowing statements is
receiving confirmation of enrollment into the MA true about a Medicare
Plan, the member must cancel their Medicare Sup- Supplement Insur-
plement Insurance policy according to their carri- ance Plan member
er's rules.
, UHC CERTIFICATION 2 LATEST VERSIONS 2024-2025 ACTUAL EXAM 2
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |
Study online at https://quizlet.com/_fvb6rv
who wants to enroll in
an MA Plan?
11. It is a government program, offered only through a Which of the fol-
private insurance company or other private compa- lowing best defines
ny approved by Medicare, which provides prescrip- Medicare Part D?
tion drug coverage.
12. To enroll, member must be in plans service area Which of the fol-
lowing is a fact
about Medicare Pre-
scription Drug Plans?
13. Enroll in a stand-alone Medicare Prescription Drug What are two op-
Plan (PDP) tions for Medicare
consumers to get Part
Enroll in a Medicare Advantage Plan or other D prescription drug
Medicare health plan that includes prescription coverage (assuming
drug coverage they meet all eligi-
bility requirements)?
(Select 2)
14. A deductible is the amount the member must pay Which of the follow-
for every prescription medication, regardless of ing statements does
what stage they are in. NOT correctly de-
fine prescription drug
stages?
15. (INCORRECT) Prior authorization, quantity limit, Which of these state-
and step therapy are some examples of UM rules ments is NOT true
about the drug uti-
lization management
(UM) rules?
16. Late Enrollment Penalty (LEP) What is the amount
added to the mem-
ber's monthly plan
premium if they did
