UHC MEDICARE CERTIFICATION / NEWEST ACTUAL
EXAM 2 VERSIONS / COMPLETE ACCURATE EXAM
QUESTIONS WITH DETAILED & VERIFIED ANSWERS
2025
Terms in this set (157)
Medicare Federal health insurance program
Medicare is administered by CMS ( Centers for medicare and medicaid services)
whom?
Parts A & B of medicarefederal health insurance program referred to as
areoriginal medicare
Part A? Hospital insurance
Part B? Medical insurance
What doesnt medicare routine dental, eye care hearing exam,deductibles, coinsurance and
cover? copayments
Part C? Medicare Advantage Plans
MA covers? Part A &B coverage, and some part D coverage
MA plans are not? Medicare supplement insurance plans
What offers lower monthly MADP
premiums MADP or
supplement?
YES
do MAP's have a annual
maximum OOP maximum
that limits the amount of
money a member must
spend every year for
covered services?
,MA plans integrate what type part D prescription drug coverage
of additonal coverage?
If a customer wants to MA-only PFFS plan
keep their stand alone
prescription drug plan,
what may the customer
want to enroll in?
What is a stand alone drug PDP
plan called?
WHat is PFFS? 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 PFFS plan
area, what type of plan may
they want because it gives
them freedom to access
doctors that may not be in
their network?
Do HMO's require referals? Yes
Do PPO's require a referal? No
When a member enrolls in a MA plan
MA plan, they receive their
coverage from medicare or
the MA plan?
Part B
When a customer is enrolled
in a MA plan, they must
continue paying their
premiums for what other
plan?
, MA plans have a maxium MOOP amount ( Maxium out of pocket)
annual limit on OOP costs
called a?
When a member is enrolled effective date
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_____?
An exception exisits for Stand alone PDP
MA-only PFFS plans as a
member can also be
enrolled in a what?
If a member enrolls in a Cancel in writing their medicare supplement insurance
MA plan, what must the policy with the carrier after their request to enroll in MA
member do? plan has been approved.
Medicare supplement MA plan
insurance policies cannot be
used in conjunction with
what type of plan?
A medicare supplement original medicare.
insurance plan helps to
cover some of the OOP
costs associated with?
A medicare supplement MA plan
insurance plan does NOT pay
the cost-sharing of what type
of plan?
NO
when a client enrolls in a
MA plan, will it
automatically terminate
their MA plan?
EXAM 2 VERSIONS / COMPLETE ACCURATE EXAM
QUESTIONS WITH DETAILED & VERIFIED ANSWERS
2025
Terms in this set (157)
Medicare Federal health insurance program
Medicare is administered by CMS ( Centers for medicare and medicaid services)
whom?
Parts A & B of medicarefederal health insurance program referred to as
areoriginal medicare
Part A? Hospital insurance
Part B? Medical insurance
What doesnt medicare routine dental, eye care hearing exam,deductibles, coinsurance and
cover? copayments
Part C? Medicare Advantage Plans
MA covers? Part A &B coverage, and some part D coverage
MA plans are not? Medicare supplement insurance plans
What offers lower monthly MADP
premiums MADP or
supplement?
YES
do MAP's have a annual
maximum OOP maximum
that limits the amount of
money a member must
spend every year for
covered services?
,MA plans integrate what type part D prescription drug coverage
of additonal coverage?
If a customer wants to MA-only PFFS plan
keep their stand alone
prescription drug plan,
what may the customer
want to enroll in?
What is a stand alone drug PDP
plan called?
WHat is PFFS? 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 PFFS plan
area, what type of plan may
they want because it gives
them freedom to access
doctors that may not be in
their network?
Do HMO's require referals? Yes
Do PPO's require a referal? No
When a member enrolls in a MA plan
MA plan, they receive their
coverage from medicare or
the MA plan?
Part B
When a customer is enrolled
in a MA plan, they must
continue paying their
premiums for what other
plan?
, MA plans have a maxium MOOP amount ( Maxium out of pocket)
annual limit on OOP costs
called a?
When a member is enrolled effective date
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_____?
An exception exisits for Stand alone PDP
MA-only PFFS plans as a
member can also be
enrolled in a what?
If a member enrolls in a Cancel in writing their medicare supplement insurance
MA plan, what must the policy with the carrier after their request to enroll in MA
member do? plan has been approved.
Medicare supplement MA plan
insurance policies cannot be
used in conjunction with
what type of plan?
A medicare supplement original medicare.
insurance plan helps to
cover some of the OOP
costs associated with?
A medicare supplement MA plan
insurance plan does NOT pay
the cost-sharing of what type
of plan?
NO
when a client enrolls in a
MA plan, will it
automatically terminate
their MA plan?
