UHC Medicare Certification – Final Exam Review Actual Questions & Answers with Rationales (2026/2027)

UHC Medicare Certification – Final Exam Review Actual
Questions & Answers with Rationales (2026/2027)
1. What is Medicare Part A primarily designed to cover?
A. Physician and outpatient services
B. Inpatient hospital and certain institutional care
C. Prescription drugs
D. Dental services
Answer: B
Rationale: Part A primarily covers inpatient hospital care, skilled
nursing facility care in qualifying circumstances, hospice care, and
certain home health services.
2. What does Medicare Part B generally cover?
A. Physician and outpatient medical services
B. Most retail prescription drugs
C. Long-term custodial care
D. Medigap premiums
Answer: A
Rationale: Part B generally covers medically necessary physician
services, outpatient services, preventive services, and certain medical
equipment.
3. Medicare Part C is commonly known as:
A. Medicare Supplement
B. Medicare Advantage
C. Medicaid
D. Part D
Answer: B
Rationale: Medicare Advantage is the Medicare Part C program offered
by Medicare-approved private organizations.

,4. Medicare Part D provides:
A. Prescription drug coverage
B. Hospital insurance
C. Medigap coverage
D. Long-term custodial care
Answer: A
Rationale: Part D provides Medicare prescription drug coverage
through stand-alone prescription drug plans and Medicare Advantage
plans that include drug coverage.
5. Which combination makes up Original Medicare?
A. Parts C and D
B. Parts A and B
C. Parts B and D
D. Medigap and Part D
Answer: B
Rationale: Original Medicare consists of Part A and Part B.
6. Medicare Advantage plans are offered by:
A. Only state Medicaid agencies
B. Medicare-approved private organizations
C. Social Security offices
D. Individual hospitals
Answer: B
Rationale: Medicare Advantage organizations contract with Medicare
to provide covered Medicare benefits under Part C.
7. What is a Medicare Advantage plan's service area?
A. The area where the agent sells insurance
B. The geographic area where the plan is offered to eligible
beneficiaries

,C. Every state in the country
D. The beneficiary's doctor's office
Answer: B
Rationale: Medicare Advantage plans have defined geographic service
areas.
8. Why is a beneficiary's residence important when discussing
Medicare Advantage enrollment?
A. It can determine which plans are available
B. It determines the beneficiary's diagnosis
C. It determines drug effectiveness
D. It determines Social Security retirement age
Answer: A
Rationale: Eligibility for many Medicare Advantage plans depends on
residing in the plan's service area.
9. Which type of Medicare Advantage plan commonly uses a network
and primary care coordination?
A. HMO
B. Medigap
C. PDP
D. Original Medicare
Answer: A
Rationale: HMOs generally use defined provider networks and
coordinated care structures.
10. Which plan type generally allows members to obtain covered
services from out-of-network providers, usually at higher cost?
A. PPO
B. HMO only

, C. Medigap
D. PDP
Answer: A
Rationale: PPOs generally provide both in-network and out-of-network
coverage, subject to plan rules and cost sharing.
11. What is a Special Needs Plan (SNP)?
A. A Medicare Advantage plan designed for certain qualifying
populations
B. A Medigap policy
C. A hospital-only plan
D. A Social Security program
Answer: A
Rationale: SNPs are Medicare Advantage plans specifically designed for
eligible beneficiaries with particular circumstances.
12. Which SNP serves certain beneficiaries who are eligible for both
Medicare and Medicaid?
A. C-SNP
B. D-SNP
C. I-SNP
D. PDP
Answer: B
Rationale: D-SNP stands for Dual Eligible Special Needs Plan.
13. What does C-SNP generally stand for?
A. Community Special Savings Plan
B. Chronic Condition Special Needs Plan
C. Comprehensive Senior Network Plan
D. Coverage Selection Network Plan