1. Which of the HMO Plans cover only in-network services. In most cases,
following is a correct members pay the full cost of any out-of-network services
statement about in- received, with a few important exceptions.
network provider ser-
vices?
Resides in the plan's service
2. Which of the following
are eligibility area Is enrolled in Medicare
requirements for
enrollment in a Part B
Medicare Advantage
(MA) Plan? (Se- lect 3) Is entitled to Medicare Part A
3. Which statement is
All MA plans have an Out-of-Pocket Maximum to help limit
true about the
Medicare Ad- vantage the mem- ber's out-of-pocket costs for Medicare-covered
(MA) Out-of-Pock- et medical services.
Maximum?
4. Which of the following best Entitled to Part A and/or enrolled in Part B and reside in
the plan
describes eligibility to en- drug tier?
roll in a stand-alone
Pre- scription Drug 7. Which of these statements is true
Plan? about the drug uti- lization
management (UM) rules?
5. Which of the
following statements
is NOT true about the
Coverage Gap?
6. Which of the
following is a
characteristics of a
1/
13
, UHC Fast Track Assessment Exam Study Guide.
ervice area.
ll members reach the Coverage Gap
ll of the drugs in the tier have the same
copayment or coinsurance.
rior authorization, quantity limit, and step
therapy are some exam- ples of the UM
rules.
2/
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