UHC Medicare Certification
Exam (2026/2027) – Actual
Questions & Answers
150 Questions and correct answers designed to reflect
the scope and rigorous compliance standards of the UHC
Medicare Certification and Agent, Broker, and Producer
(ABP) testing modules
Part 1: Medicare Basics and General Compliance (Q1–
Q30)
Q: What federal agency administers the Medicare program in the United
States?
A: Centers for Medicare & Medicaid Services (CMS).
Q: What is Original Medicare primarily composed of?
A: Part A (Hospital Insurance) and Part B (Medical Insurance).
Q: What does Medicare Part A generally cover?
A: Inpatient hospital stays, skilled nursing facility care, hospice care, and
some home health care.
Q: What does Medicare Part B generally cover?
A: Doctor services, outpatient care, medical supplies, and preventive
services.
Q: What is Medicare Part C commonly known as?
A: Medicare Advantage (MA).
Q: What is Medicare Part D?
A: Prescription drug coverage.
Q: Can an individual enrolled in Original Medicare also enroll in a stand-alone
Prescription Drug Plan (PDP)?
,A: Yes.
Q: Can a Medicare Advantage plan be combined with a stand-alone Medicare
Part D prescription drug plan?
A: No, because most Medicare Advantage plans (MAPDs) already include
integrated prescription drug coverage. Enrolling in a separate PDP will
usually disenroll the member from their MAPD.
Q: What is the primary purpose of the Annual Election Period (AEP)?
A: To allow beneficiaries to make changes to their Medicare Advantage and
prescription drug coverage for the upcoming year.
Q: What are the fixed dates for the Medicare Annual Election Period (AEP)?
A: October 15 through December 7 of each year.
Q: When do changes made during the AEP typically take effect?
A: January 1 of the following year.
Q: What is the Medicare Advantage Open Enrollment Period (MA OEP) date
range?
A: January 1 through March 31.
Q: What is permitted during the MA OEP for individuals already enrolled in a
Medicare Advantage plan?
A: They can switch to another Medicare Advantage plan or disenroll from
Medicare Advantage and return to Original Medicare (with or without a Part D
plan).
Q: Can individuals using the MA OEP switch from Original Medicare to a
Medicare Advantage plan if they did not previously have one?
A: No.
Q: What does SEP stand for in Medicare terminology?
A: Special Election Period.
Q: What triggers a Special Election Period (SEP)?
A: Specific qualifying life events, such as moving out of the plan’s service
area, losing employer-sponsored coverage, or qualifying for Extra Help.
, Q: What is the term for government financial assistance that helps low-
income beneficiaries pay for Medicare Part D costs?
A: Extra Help (Low-Income Subsidy / LIS).
Q: What is Medigap?
A: Medicare Supplement Insurance sold by private companies to fill "gaps" in
Original Medicare coverage.
Q: Can a person have both a Medicare Advantage plan and a Medigap policy
at the same time?
A: No, it is illegal for an agent to sell a Medigap policy to someone enrolled in
a Medicare Advantage plan.
Q: What is the standard Medicare Part B late enrollment penalty?
A: A 10% premium increase for each 12-month period a person could have
had Part B but didn't sign up.
Q: What is the standard Medicare Part D late enrollment penalty?
A: An amount added to the monthly premium if there is a continuous period
of 63 days or more without creditable prescription drug coverage.
Q: What constitutes creditable prescription drug coverage?
A: Coverage that is expected to pay, on average, as much as standard
Medicare Part D prescription drug coverage.
Q: What is the formal document that provides a summary of a Medicare
plan’s benefits, premiums, and cost-sharing?
A: Summary of Benefits (SB).
Q: What document outlines detailed medical benefits, coverage rules, and
member rights for a plan?
A: Evidence of Coverage (EOC).
Q: What is the Annual Notice of Change (ANOC)?
A: A document sent to current members every September detailing any
changes in coverage, costs, or service area for the upcoming year.
Q: When must insurers mail the ANOC to current plan members?
A: By September 30 of each year.
Exam (2026/2027) – Actual
Questions & Answers
150 Questions and correct answers designed to reflect
the scope and rigorous compliance standards of the UHC
Medicare Certification and Agent, Broker, and Producer
(ABP) testing modules
Part 1: Medicare Basics and General Compliance (Q1–
Q30)
Q: What federal agency administers the Medicare program in the United
States?
A: Centers for Medicare & Medicaid Services (CMS).
Q: What is Original Medicare primarily composed of?
A: Part A (Hospital Insurance) and Part B (Medical Insurance).
Q: What does Medicare Part A generally cover?
A: Inpatient hospital stays, skilled nursing facility care, hospice care, and
some home health care.
Q: What does Medicare Part B generally cover?
A: Doctor services, outpatient care, medical supplies, and preventive
services.
Q: What is Medicare Part C commonly known as?
A: Medicare Advantage (MA).
Q: What is Medicare Part D?
A: Prescription drug coverage.
Q: Can an individual enrolled in Original Medicare also enroll in a stand-alone
Prescription Drug Plan (PDP)?
,A: Yes.
Q: Can a Medicare Advantage plan be combined with a stand-alone Medicare
Part D prescription drug plan?
A: No, because most Medicare Advantage plans (MAPDs) already include
integrated prescription drug coverage. Enrolling in a separate PDP will
usually disenroll the member from their MAPD.
Q: What is the primary purpose of the Annual Election Period (AEP)?
A: To allow beneficiaries to make changes to their Medicare Advantage and
prescription drug coverage for the upcoming year.
Q: What are the fixed dates for the Medicare Annual Election Period (AEP)?
A: October 15 through December 7 of each year.
Q: When do changes made during the AEP typically take effect?
A: January 1 of the following year.
Q: What is the Medicare Advantage Open Enrollment Period (MA OEP) date
range?
A: January 1 through March 31.
Q: What is permitted during the MA OEP for individuals already enrolled in a
Medicare Advantage plan?
A: They can switch to another Medicare Advantage plan or disenroll from
Medicare Advantage and return to Original Medicare (with or without a Part D
plan).
Q: Can individuals using the MA OEP switch from Original Medicare to a
Medicare Advantage plan if they did not previously have one?
A: No.
Q: What does SEP stand for in Medicare terminology?
A: Special Election Period.
Q: What triggers a Special Election Period (SEP)?
A: Specific qualifying life events, such as moving out of the plan’s service
area, losing employer-sponsored coverage, or qualifying for Extra Help.
, Q: What is the term for government financial assistance that helps low-
income beneficiaries pay for Medicare Part D costs?
A: Extra Help (Low-Income Subsidy / LIS).
Q: What is Medigap?
A: Medicare Supplement Insurance sold by private companies to fill "gaps" in
Original Medicare coverage.
Q: Can a person have both a Medicare Advantage plan and a Medigap policy
at the same time?
A: No, it is illegal for an agent to sell a Medigap policy to someone enrolled in
a Medicare Advantage plan.
Q: What is the standard Medicare Part B late enrollment penalty?
A: A 10% premium increase for each 12-month period a person could have
had Part B but didn't sign up.
Q: What is the standard Medicare Part D late enrollment penalty?
A: An amount added to the monthly premium if there is a continuous period
of 63 days or more without creditable prescription drug coverage.
Q: What constitutes creditable prescription drug coverage?
A: Coverage that is expected to pay, on average, as much as standard
Medicare Part D prescription drug coverage.
Q: What is the formal document that provides a summary of a Medicare
plan’s benefits, premiums, and cost-sharing?
A: Summary of Benefits (SB).
Q: What document outlines detailed medical benefits, coverage rules, and
member rights for a plan?
A: Evidence of Coverage (EOC).
Q: What is the Annual Notice of Change (ANOC)?
A: A document sent to current members every September detailing any
changes in coverage, costs, or service area for the upcoming year.
Q: When must insurers mail the ANOC to current plan members?
A: By September 30 of each year.
