UHC 2025 AHIP - MEDICARE BASICS ASSESSMENT
(MEDICARE ADVANTAGE [NON-SNP], PRESCRIPTION
DRUG AND MEDICARE SUPPLEMENT PLANS) A GUIDE
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1. Lisa turned 65 and is now eligible for Medicare. She already receives Social
Security benefits. How does she enroll in Original Medicare? ANS >> Her
enrollment in Medicare Parts A and B is generally automatic if she meets all
eligibility require- ments.
2. Which statement is true about a member of a Medicare Advantage (MA) Plan
who wants to enroll in a Medicare Supplement Insurance Plan? ANS >> When
a con- sumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
3. Being 65 or older, being under 65 years of age with a qualifying disability or
being any age with ESRD or ALS are each eligibility requirements for which
program? ANS >> Original Medicare
4. Which of the following defines a Medicare Advantage (MA) Plan? (Select
3) ANS >> -An MA Plan is part of Medicare and is also called Part C.
-An MA Plan is a health plan option approved by Medicare and offered by private
insurance companies.
-An MA Plan provides Medicare hospital and medical insurance (Medicare Part A
and Part B) and often includes Medicare prescription drug coverage (Part D).
5. To be eligible for this plan type, consumers must meet the following require-
ments ANS >> be entitled to Medicare Part A and enrolled in Part B, and reside
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, in the plan's service area. Which plan is being described? ANS >> Medicare
Advantage
6. Which of the following is a correct statement about in-network provider
services? ANS >> HMO Plans cover only in-network services. In most cases,
members pay the full cost of any out-of-network services received, with a few
important exceptions.
7. Which of the following is NOT a correct statement about in-network provider
services? ANS >> HMO-POS Plans only cover in-network services.
8. Which statement is true about Medicare Supplement Open Enrollment?
ANS >> It is the six-month period that starts the month the consumer is 65 or older
and is enrolled in Medicare Part B.
9. Which statement is true about the Medicare Advantage (MA) Out-of-Pocket
Maximum? ANS >> All MA plans have an Out-of-Pocket Maximum to help limit the
mem- ber's out-of-pocket costs for Medicare-covered medical services.
10. Margaret currently has an MAPD Plan. What would happen if you enrolled
her into a stand-alone PDP? ANS >> She would be disenrolled automatically from
her MAPD Plan.
11. What is Medicare Part D? ANS >> A voluntary program, offered by private
insurance companies that are contracted with the federal government, that
provides prescrip- tion drug coverage for an additional monthly plan premium.
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(MEDICARE ADVANTAGE [NON-SNP], PRESCRIPTION
DRUG AND MEDICARE SUPPLEMENT PLANS) A GUIDE
1. Lisa turned 65 and is now eligible for Medicare. She already receives Social
Security benefits. How does she enroll in Original Medicare? ANS >> Her
enrollment in Medicare Parts A and B is generally automatic if she meets all
eligibility require- ments.
2. Which statement is true about a member of a Medicare Advantage (MA) Plan
who wants to enroll in a Medicare Supplement Insurance Plan? ANS >> When
a con- sumer enrolls in a Medicare Supplement Insurance Plan, they are not
automatically disenrolled from their MA Plan.
3. Being 65 or older, being under 65 years of age with a qualifying disability or
being any age with ESRD or ALS are each eligibility requirements for which
program? ANS >> Original Medicare
4. Which of the following defines a Medicare Advantage (MA) Plan? (Select
3) ANS >> -An MA Plan is part of Medicare and is also called Part C.
-An MA Plan is a health plan option approved by Medicare and offered by private
insurance companies.
-An MA Plan provides Medicare hospital and medical insurance (Medicare Part A
and Part B) and often includes Medicare prescription drug coverage (Part D).
5. To be eligible for this plan type, consumers must meet the following require-
ments ANS >> be entitled to Medicare Part A and enrolled in Part B, and reside
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, in the plan's service area. Which plan is being described? ANS >> Medicare
Advantage
6. Which of the following is a correct statement about in-network provider
services? ANS >> HMO Plans cover only in-network services. In most cases,
members pay the full cost of any out-of-network services received, with a few
important exceptions.
7. Which of the following is NOT a correct statement about in-network provider
services? ANS >> HMO-POS Plans only cover in-network services.
8. Which statement is true about Medicare Supplement Open Enrollment?
ANS >> It is the six-month period that starts the month the consumer is 65 or older
and is enrolled in Medicare Part B.
9. Which statement is true about the Medicare Advantage (MA) Out-of-Pocket
Maximum? ANS >> All MA plans have an Out-of-Pocket Maximum to help limit the
mem- ber's out-of-pocket costs for Medicare-covered medical services.
10. Margaret currently has an MAPD Plan. What would happen if you enrolled
her into a stand-alone PDP? ANS >> She would be disenrolled automatically from
her MAPD Plan.
11. What is Medicare Part D? ANS >> A voluntary program, offered by private
insurance companies that are contracted with the federal government, that
provides prescrip- tion drug coverage for an additional monthly plan premium.
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