UHC MEDICARE BASICS LATEST UPDATED
QUESTIONS AND ANSWERS RATED A+
✔✔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.
✔✔Which of the following are eligibility requirements for enrollment in a Medicare
Advantage Plan? (Select 3) - ✔✔-Is entitled to Medicare Part A
-Is enrolled in Medicare Part B
-Resides in the plan's service area
✔✔Which of the following is a correct statement about in-network provider services? -
✔✔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.
✔✔Which of the following is NOT a correct statement about in-network provider
services? - ✔✔HMO-POS Plans only cover in-network services.
✔✔Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what
counts toward the Out-of-Pocket Maximum. Which of the following is accurate? -
✔✔The Out-of-Pocket Maximum will include her costs toward any Medicare-covered
Part A or B services but does not include the cost of any plan premiums.
✔✔Margaret currently has an MAPD Plan. What would happen if you enrolled her into a
stand-alone PDP? - ✔✔She would be disenrolled automatically from her MAPD Plan.
✔✔Which of the following best describes eligibility to enroll in a stand-alone Prescription
Drug Plan? - ✔✔Entitled to Part A and/or enrolled in Part B and reside in the plan
service area.
, ✔✔Aside from a Medicare Advantage Plan or other health plan that includes
prescription drug coverage, how else could a Medicare-eligible consumer get Part D
prescription drug coverage? - ✔✔They could enroll in a stand-alone Medicare
Prescription Drug Plan (PDP).
✔✔Which of the following statements is NOT true about the Coverage Gap? - ✔✔All
members reach the Coverage Gap.
✔✔Which of these statements is NOT true about the drug utilization management (UM)
rules? - ✔✔
✔✔Which of the following best describes the Late Enrollment Penalty (LEP)? - ✔✔The
amount added to the member's monthly plan premium if they did not enroll in a
Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan
when they were first eligible for Medicare Parts A and/or B or went without creditable
prescription drug coverage for 63 or more continuous days.
✔✔Through which means is financial assistance offered to a consumer who qualifies for
Low Income Subsidy for their part of Medicare Part D costs? - ✔✔Through subsidies
such as lower or no monthly plan premiums and lower or no copayments.
✔✔Formulary is defined as: - ✔✔A list of medications covered within the benefit plan,
based on CMS guidelines and developed in collaboration with physicians and
pharmacists.
✔✔The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which went
into effect January 1, 2020, applies to all carriers offering Medicare supplement plans. -
✔✔True
✔✔What kind of financial assistance does a consumer receive who qualifies for Low
Income Subsidy - ✔✔Lower or no monthly plan premiums and lower or no copayments
✔✔What is the Late Enrollment Penalty (LEP) amount for not enrolling in a Medicare
Advantage plan with Part D benefits or a stand-alone prescription drug plan? - ✔✔The
Late Enrollment Penalty is added to the member's monthly plan premium if they did not
enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription
drug plan when they were first eligible for Medicare Parts A and/or B or went without
creditable prescription drug coverage for 63 or more continuous days.
✔✔What is the purpose of Step Therapy in Medicare Advantage Plans? - ✔✔Step
Therapy is a utilization management rule that requires members to try a less expensive
drug before moving on to a more costly one, helping to control costs and ensure
appropriate medication use.
QUESTIONS AND ANSWERS RATED A+
✔✔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.
✔✔Which of the following are eligibility requirements for enrollment in a Medicare
Advantage Plan? (Select 3) - ✔✔-Is entitled to Medicare Part A
-Is enrolled in Medicare Part B
-Resides in the plan's service area
✔✔Which of the following is a correct statement about in-network provider services? -
✔✔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.
✔✔Which of the following is NOT a correct statement about in-network provider
services? - ✔✔HMO-POS Plans only cover in-network services.
✔✔Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what
counts toward the Out-of-Pocket Maximum. Which of the following is accurate? -
✔✔The Out-of-Pocket Maximum will include her costs toward any Medicare-covered
Part A or B services but does not include the cost of any plan premiums.
✔✔Margaret currently has an MAPD Plan. What would happen if you enrolled her into a
stand-alone PDP? - ✔✔She would be disenrolled automatically from her MAPD Plan.
✔✔Which of the following best describes eligibility to enroll in a stand-alone Prescription
Drug Plan? - ✔✔Entitled to Part A and/or enrolled in Part B and reside in the plan
service area.
, ✔✔Aside from a Medicare Advantage Plan or other health plan that includes
prescription drug coverage, how else could a Medicare-eligible consumer get Part D
prescription drug coverage? - ✔✔They could enroll in a stand-alone Medicare
Prescription Drug Plan (PDP).
✔✔Which of the following statements is NOT true about the Coverage Gap? - ✔✔All
members reach the Coverage Gap.
✔✔Which of these statements is NOT true about the drug utilization management (UM)
rules? - ✔✔
✔✔Which of the following best describes the Late Enrollment Penalty (LEP)? - ✔✔The
amount added to the member's monthly plan premium if they did not enroll in a
Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan
when they were first eligible for Medicare Parts A and/or B or went without creditable
prescription drug coverage for 63 or more continuous days.
✔✔Through which means is financial assistance offered to a consumer who qualifies for
Low Income Subsidy for their part of Medicare Part D costs? - ✔✔Through subsidies
such as lower or no monthly plan premiums and lower or no copayments.
✔✔Formulary is defined as: - ✔✔A list of medications covered within the benefit plan,
based on CMS guidelines and developed in collaboration with physicians and
pharmacists.
✔✔The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which went
into effect January 1, 2020, applies to all carriers offering Medicare supplement plans. -
✔✔True
✔✔What kind of financial assistance does a consumer receive who qualifies for Low
Income Subsidy - ✔✔Lower or no monthly plan premiums and lower or no copayments
✔✔What is the Late Enrollment Penalty (LEP) amount for not enrolling in a Medicare
Advantage plan with Part D benefits or a stand-alone prescription drug plan? - ✔✔The
Late Enrollment Penalty is added to the member's monthly plan premium if they did not
enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription
drug plan when they were first eligible for Medicare Parts A and/or B or went without
creditable prescription drug coverage for 63 or more continuous days.
✔✔What is the purpose of Step Therapy in Medicare Advantage Plans? - ✔✔Step
Therapy is a utilization management rule that requires members to try a less expensive
drug before moving on to a more costly one, helping to control costs and ensure
appropriate medication use.
