UHC CERTIFICATION EXAM ANSWERED
CORRECTLY FINAL STUDY GUIDE 2026
QUESTIONS WITH ANSWERS GRADED A+
⫸ Which statement is true about a member of a Medicare Advantage
(MA) Plan who wants to enroll in a Medicare Supplement Insurance
Plan? 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? Answer:
Original Medicare
⫸ Which of the following defines a Medicare Advantage (MA) Plan?
(Select 2) Answer: 1. MA Plans must provide benefits equivalent to
Original Medicare, and most plans also offer additional benefits.
2. MA Plans provide Medicare hospital and medical insurance and often
include Medicare prescription drug coverage.
⫸ Which of the following is NOT an eligibility requirement for
enrollment in a Medicare Advantage Plan? 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?
Answer: Members must receive covered services from contracted
network providers with limited exceptions.
⫸ Which of the following is NOT a correct statement about in-network
provider services? Answer: (INCORRECT) Network-based MA plans
have a provider network the member can use, and some plans also cover
certain services outside the network.
⫸ What is true about Medicare supplement open enrollment? Answer:
(INCORRECT) A consumer who waits to enroll in Medicare Part B
until age 66 or older cannot qualify for Medicare Supplement Open
Enrollment.
(INCORRECT) It is the only time a consumer is eligible to purchase a
Medicare Supplement Insurance Plan.
⫸ 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? Answer: The Out-of-Pocket Maximum will
include her costs toward any Medicare-covered Part A or B services.
⫸ Which of the following statements is true about a Medicare
Supplement Insurance Plan member who wants to enroll in an MA Plan?
Answer: Medicare Supplement Insurance cannot be used in conjunction
with an MA Plan; therefore, after receiving confirmation of enrollment
, into the MA Plan, the member must cancel their Medicare Supplement
Insurance policy according to their carrier's rules.
⫸ Which of the following best defines Medicare Part D? Answer: It is a
government program, offered only through a private insurance company
or other private company approved by Medicare, which provides
prescription drug coverage.
⫸ Which of the following is a fact about Medicare Prescription Drug
Plans? Answer: To enroll, member must be in plans service area
⫸ What are two options for Medicare consumers to get Part D
prescription drug coverage (assuming they meet all eligibility
requirements)? (Select 2) Answer: Enroll in a stand-alone Medicare
Prescription Drug Plan (PDP)
Enroll in a Medicare Advantage Plan or other Medicare health plan that
includes prescription drug coverage
⫸ Which of the following statements does NOT correctly define
prescription drug stages? Answer: A deductible is the amount the
member must pay for every prescription medication, regardless of what
stage they are in.
⫸ Which of these statements is NOT true about the drug utilization
management (UM) rules? Answer: (INCORRECT) Prior authorization,
quantity limit, and step therapy are some examples of UM rules
CORRECTLY FINAL STUDY GUIDE 2026
QUESTIONS WITH ANSWERS GRADED A+
⫸ Which statement is true about a member of a Medicare Advantage
(MA) Plan who wants to enroll in a Medicare Supplement Insurance
Plan? 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? Answer:
Original Medicare
⫸ Which of the following defines a Medicare Advantage (MA) Plan?
(Select 2) Answer: 1. MA Plans must provide benefits equivalent to
Original Medicare, and most plans also offer additional benefits.
2. MA Plans provide Medicare hospital and medical insurance and often
include Medicare prescription drug coverage.
⫸ Which of the following is NOT an eligibility requirement for
enrollment in a Medicare Advantage Plan? 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?
Answer: Members must receive covered services from contracted
network providers with limited exceptions.
⫸ Which of the following is NOT a correct statement about in-network
provider services? Answer: (INCORRECT) Network-based MA plans
have a provider network the member can use, and some plans also cover
certain services outside the network.
⫸ What is true about Medicare supplement open enrollment? Answer:
(INCORRECT) A consumer who waits to enroll in Medicare Part B
until age 66 or older cannot qualify for Medicare Supplement Open
Enrollment.
(INCORRECT) It is the only time a consumer is eligible to purchase a
Medicare Supplement Insurance Plan.
⫸ 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? Answer: The Out-of-Pocket Maximum will
include her costs toward any Medicare-covered Part A or B services.
⫸ Which of the following statements is true about a Medicare
Supplement Insurance Plan member who wants to enroll in an MA Plan?
Answer: Medicare Supplement Insurance cannot be used in conjunction
with an MA Plan; therefore, after receiving confirmation of enrollment
, into the MA Plan, the member must cancel their Medicare Supplement
Insurance policy according to their carrier's rules.
⫸ Which of the following best defines Medicare Part D? Answer: It is a
government program, offered only through a private insurance company
or other private company approved by Medicare, which provides
prescription drug coverage.
⫸ Which of the following is a fact about Medicare Prescription Drug
Plans? Answer: To enroll, member must be in plans service area
⫸ What are two options for Medicare consumers to get Part D
prescription drug coverage (assuming they meet all eligibility
requirements)? (Select 2) Answer: Enroll in a stand-alone Medicare
Prescription Drug Plan (PDP)
Enroll in a Medicare Advantage Plan or other Medicare health plan that
includes prescription drug coverage
⫸ Which of the following statements does NOT correctly define
prescription drug stages? Answer: A deductible is the amount the
member must pay for every prescription medication, regardless of what
stage they are in.
⫸ Which of these statements is NOT true about the drug utilization
management (UM) rules? Answer: (INCORRECT) Prior authorization,
quantity limit, and step therapy are some examples of UM rules
