UHC certification
Study online at https://quizlet.com/_5pxt7z
1. Medicare Federal health insurance program
2. Medicare is administered CMS ( Centers for medicare and medicaid services)
by whom?
3. Parts A & B of medicare are federal health insurance program referred to as original medicare
4. Part A? Hospital insurance
5. Part B? Medical insurance
6. What doesnt medicare cov- routine dental, eye care hearing exam,deductibles, coinsurance
er? and copayments
7. Part C? Medicare Advantage Plans
8. MA covers? Part A &B coverage, and some part D coverage
9. MA plans are not? Medicare supplement insurance plans
10. What offers lower monthly MADP
premiums MADP or supple-
ment?
11. do MAP's have a annual YES
maximum OOP maximum
that limits the amount of
money a member must
spend every year for cov-
ered services?
12. MA plans integrate what part D prescription drug coverage
type of additonal coverage?
13. MA-only PFFS plan
, UHC certification
Study online at https://quizlet.com/_5pxt7z
If a customer wants to keep
their stand alone prescrip-
tion drug plan, what may
the customer want to enroll
in?
14. What is a stand alone drug PDP
plan called?
15. WHat is PFFS? Private Fee for Service (PFFS) - Plans that allow you to go to any
doctor or hospital that accepts their terms
16. If a customer lives in a rur- PFFS plan
al area, what type of plan
may they want because it
gives them freedom to ac-
cess doctors that may not
be in their network?
17. Do HMO's require referals? Yes
18. Do PPO's require a referal? No
19. When a member enrolls in a MA plan
MA plan, they receive their
coverage from medicare or
the MA plan?
20. When a customer is en- Part B
rolled in a MA plan, they
must continue paying their
premiums for what other
plan?
, UHC certification
Study online at https://quizlet.com/_5pxt7z
21. MA plans have a maxium MOOP amount ( Maxium out of pocket)
annual limit on OOP costs
called a?
22. When a member is enrolled effective date
in a MA plan, they are auto-
matically disenrolled from
any other MA plan or PDP(
prescription drug plan) in
which they are enrolled as
of the new plans_____?
23. An exception exisits for Stand alone PDP
MA-only PFFS plans as a
member can also be en-
rolled in a what?
24. If a member enrolls in a MA Cancel in writing their medicare supplement insurance policy with
plan, what must the mem- the carrier after their request to enroll in MA plan has been ap-
ber do? proved.
25. Medicare supplement in- MA plan
surance policies cannot be
used in conjunction with
what type of plan?
26. A medicare supplement in- original medicare.
surance plan helps to cover
some of the OOP costs as-
sociated with?
27. A medicare supplement in- MA plan
surance plan does NOT pay
Study online at https://quizlet.com/_5pxt7z
1. Medicare Federal health insurance program
2. Medicare is administered CMS ( Centers for medicare and medicaid services)
by whom?
3. Parts A & B of medicare are federal health insurance program referred to as original medicare
4. Part A? Hospital insurance
5. Part B? Medical insurance
6. What doesnt medicare cov- routine dental, eye care hearing exam,deductibles, coinsurance
er? and copayments
7. Part C? Medicare Advantage Plans
8. MA covers? Part A &B coverage, and some part D coverage
9. MA plans are not? Medicare supplement insurance plans
10. What offers lower monthly MADP
premiums MADP or supple-
ment?
11. do MAP's have a annual YES
maximum OOP maximum
that limits the amount of
money a member must
spend every year for cov-
ered services?
12. MA plans integrate what part D prescription drug coverage
type of additonal coverage?
13. MA-only PFFS plan
, UHC certification
Study online at https://quizlet.com/_5pxt7z
If a customer wants to keep
their stand alone prescrip-
tion drug plan, what may
the customer want to enroll
in?
14. What is a stand alone drug PDP
plan called?
15. WHat is PFFS? Private Fee for Service (PFFS) - Plans that allow you to go to any
doctor or hospital that accepts their terms
16. If a customer lives in a rur- PFFS plan
al area, what type of plan
may they want because it
gives them freedom to ac-
cess doctors that may not
be in their network?
17. Do HMO's require referals? Yes
18. Do PPO's require a referal? No
19. When a member enrolls in a MA plan
MA plan, they receive their
coverage from medicare or
the MA plan?
20. When a customer is en- Part B
rolled in a MA plan, they
must continue paying their
premiums for what other
plan?
, UHC certification
Study online at https://quizlet.com/_5pxt7z
21. MA plans have a maxium MOOP amount ( Maxium out of pocket)
annual limit on OOP costs
called a?
22. When a member is enrolled effective date
in a MA plan, they are auto-
matically disenrolled from
any other MA plan or PDP(
prescription drug plan) in
which they are enrolled as
of the new plans_____?
23. An exception exisits for Stand alone PDP
MA-only PFFS plans as a
member can also be en-
rolled in a what?
24. If a member enrolls in a MA Cancel in writing their medicare supplement insurance policy with
plan, what must the mem- the carrier after their request to enroll in MA plan has been ap-
ber do? proved.
25. Medicare supplement in- MA plan
surance policies cannot be
used in conjunction with
what type of plan?
26. A medicare supplement in- original medicare.
surance plan helps to cover
some of the OOP costs as-
sociated with?
27. A medicare supplement in- MA plan
surance plan does NOT pay
