UHC MEDICARE BASICS 2025
COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS/SOLUTIONS |
MULTIPLE CHOICES |solved!
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. - CORRECT ANSWER-
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. - CORRECT ANSWER-
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 - CORRECT ANSWER- 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. - CORRECT ANSWER- 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 - CORRECT ANSWER- 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. (??)
There are no exceptions to the provider network requirement for obtaining certain services from out-of-
network providers.
Most benefits are covered out-of-network but at a higher cost. (X)
Members that use out-of-network providers for routine office visits must pay a penalty in addition to
any copayment. (X) - CORRECT ANSWER- ...
Which of the following is NOT a correct statement about in-network provider services?
HMO-POS Plans only cover in-network services.
Network-based MA plans have a provider network the member can use, and some plans also cover
certain services outside the network.
PPO Plans cover in-network and out-of-network services, but out-of-network services will generally have
a high cost share to the member.
COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS/SOLUTIONS |
MULTIPLE CHOICES |solved!
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. - CORRECT ANSWER-
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. - CORRECT ANSWER-
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 - CORRECT ANSWER- 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. - CORRECT ANSWER- 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 - CORRECT ANSWER- 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. (??)
There are no exceptions to the provider network requirement for obtaining certain services from out-of-
network providers.
Most benefits are covered out-of-network but at a higher cost. (X)
Members that use out-of-network providers for routine office visits must pay a penalty in addition to
any copayment. (X) - CORRECT ANSWER- ...
Which of the following is NOT a correct statement about in-network provider services?
HMO-POS Plans only cover in-network services.
Network-based MA plans have a provider network the member can use, and some plans also cover
certain services outside the network.
PPO Plans cover in-network and out-of-network services, but out-of-network services will generally have
a high cost share to the member.
