UHC MEDICARE BASICS FINAL PAPER 2025/2026 ANSWERS
AND QUESTIONS GRADED A+
✔✔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?
Drug tiers
Deductible
Out-of-Pocket expenses
Formulary prescriptions - ✔✔Drug tiers
✔✔When is a Medicare Supplement Insurance consumer subject to underwriting and
screened for eligibility?
Only when the consumer is in their Medicare Supplement Open Enrollment.
Always to determine their acceptance.
When the consumer is not in their Medicare Supplement Open Enrollment or does not
meet Guaranteed Issue criteria.
Only when the consumer meets Guaranteed Issue criteria applicable in their state. -
✔✔When the consumer is not in their Medicare Supplement Open Enrollment or does
not meet Guaranteed Issue criteria.
✔✔Which of the following are true about the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA) Plans and the impact to Plans C and F? (Select
2)
Consumers already enrolled in Plans C or F are required to change plans.
Consumers eligible for Medicare Part A on or after January 1, 2020, will not be able to
purchase Medicare Supplement Insurance Plans C or F.
Consumers eligible for Medicare Part A before January 1, 2020, can enroll in Plan C or
F even after 2020 and can keep their plans as long as they choose. - ✔✔Consumers
eligible for Medicare Part A on or after January 1, 2020, will not be able to purchase
Medicare Supplement Insurance Plans C or F.
Consumers eligible for Medicare Part A before January 1, 2020, can enroll in Plan C or
F even after 2020 and can keep their plans as long as they choose.
✔✔Which of the following is NOT true of Medicare Supplement Insurance Plans?
Insured members must have their care coordinated through a primary care provider.
They are regulated by each state's Department of Insurance.
They can be purchased at any time of the year. - ✔✔...
✔✔ Milton is retiring on his 65th birthday. He is eligible for Medicare and already
receives Social Security benefits. How does he enroll in Original Medicare?
-He can only sign up for Medicare Parts A and/or B at his local Social Security office.
-He can sign up for Medicare Parts A and/or B with any licensed insurance agent.
-His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements
, -He must enroll in Medicare Parts A and B through his current or former employer. -
✔✔His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements
✔✔Which statement is true about a member of a Medicare Advantage (MA) Plan who
wants to enroll in a Medicare Supplement Insurance Plan?
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are
automatically disenrolled from their MA Plan.
A consumer can use a Medicare Supplement Insurance Plan and an MA Plan at the
same time.
A member does not need a valid election period to disenroll from an MA plan. -
✔✔When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
✔✔Being 65 or older, being under 65 years of age with certain disabilities for more than
24 months, and being any age with ESRD or ALS are each eligibility requirements for
which program?
Medicaid
Low Income Subsidy
Original Medicare - ✔✔Original Medicare
✔✔Which of the following defines a Medicare Advantage (MA) Plan?
MA Plans provide Medicare hospital and medical insurance but never include any
Medicare prescription drug coverage.
MA Plans are health plan options approved by Medicare and offered by private
insurance companies.
MA Plans must only provide benefits equivalent to Original Medicare and are not
allowed to offer additional benefits.
MA Plans are part of Medicare and are also called Part B. - ✔✔MA Plans are health
plan options approved by Medicare and offered by private insurance companies.
✔✔Which of the following is NOT an eligibility requirement for enrollment in a Medicare
Advantage Plan?
Does not have any pre-existing conditions such as diabetes or End Stage Renal
Disease (ESRD)
Is enrolled in Medicare Part B
Is entitled to Medicare Part A
Resides in the plan's service area - ✔✔Does not have any pre-existing conditions such
as diabetes or End Stage Renal Disease (ESRD)
✔✔Which of the following statements is correct about HMO MA Plans?
Members must receive covered services from contracted network providers. (??)
AND QUESTIONS GRADED A+
✔✔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?
Drug tiers
Deductible
Out-of-Pocket expenses
Formulary prescriptions - ✔✔Drug tiers
✔✔When is a Medicare Supplement Insurance consumer subject to underwriting and
screened for eligibility?
Only when the consumer is in their Medicare Supplement Open Enrollment.
Always to determine their acceptance.
When the consumer is not in their Medicare Supplement Open Enrollment or does not
meet Guaranteed Issue criteria.
Only when the consumer meets Guaranteed Issue criteria applicable in their state. -
✔✔When the consumer is not in their Medicare Supplement Open Enrollment or does
not meet Guaranteed Issue criteria.
✔✔Which of the following are true about the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA) Plans and the impact to Plans C and F? (Select
2)
Consumers already enrolled in Plans C or F are required to change plans.
Consumers eligible for Medicare Part A on or after January 1, 2020, will not be able to
purchase Medicare Supplement Insurance Plans C or F.
Consumers eligible for Medicare Part A before January 1, 2020, can enroll in Plan C or
F even after 2020 and can keep their plans as long as they choose. - ✔✔Consumers
eligible for Medicare Part A on or after January 1, 2020, will not be able to purchase
Medicare Supplement Insurance Plans C or F.
Consumers eligible for Medicare Part A before January 1, 2020, can enroll in Plan C or
F even after 2020 and can keep their plans as long as they choose.
✔✔Which of the following is NOT true of Medicare Supplement Insurance Plans?
Insured members must have their care coordinated through a primary care provider.
They are regulated by each state's Department of Insurance.
They can be purchased at any time of the year. - ✔✔...
✔✔ Milton is retiring on his 65th birthday. He is eligible for Medicare and already
receives Social Security benefits. How does he enroll in Original Medicare?
-He can only sign up for Medicare Parts A and/or B at his local Social Security office.
-He can sign up for Medicare Parts A and/or B with any licensed insurance agent.
-His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements
, -He must enroll in Medicare Parts A and B through his current or former employer. -
✔✔His enrollment in Medicare Parts A and B is generally automatic if he meets all
eligibility requirements
✔✔Which statement is true about a member of a Medicare Advantage (MA) Plan who
wants to enroll in a Medicare Supplement Insurance Plan?
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are
automatically disenrolled from their MA Plan.
A consumer can use a Medicare Supplement Insurance Plan and an MA Plan at the
same time.
A member does not need a valid election period to disenroll from an MA plan. -
✔✔When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
✔✔Being 65 or older, being under 65 years of age with certain disabilities for more than
24 months, and being any age with ESRD or ALS are each eligibility requirements for
which program?
Medicaid
Low Income Subsidy
Original Medicare - ✔✔Original Medicare
✔✔Which of the following defines a Medicare Advantage (MA) Plan?
MA Plans provide Medicare hospital and medical insurance but never include any
Medicare prescription drug coverage.
MA Plans are health plan options approved by Medicare and offered by private
insurance companies.
MA Plans must only provide benefits equivalent to Original Medicare and are not
allowed to offer additional benefits.
MA Plans are part of Medicare and are also called Part B. - ✔✔MA Plans are health
plan options approved by Medicare and offered by private insurance companies.
✔✔Which of the following is NOT an eligibility requirement for enrollment in a Medicare
Advantage Plan?
Does not have any pre-existing conditions such as diabetes or End Stage Renal
Disease (ESRD)
Is enrolled in Medicare Part B
Is entitled to Medicare Part A
Resides in the plan's service area - ✔✔Does not have any pre-existing conditions such
as diabetes or End Stage Renal Disease (ESRD)
✔✔Which of the following statements is correct about HMO MA Plans?
Members must receive covered services from contracted network providers. (??)
