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UHC 24 MEDICARE BASICS FINAL
PAPER QUESTIONS WITH VERIFIED
ANSWERS COMPLETE SET

◉ Which of the following are MA Plans that focus on using network
providers to maximize the benefits and reduce out-of-network
expenses? Answer: HMO, POS, PPO


◉ When does Medicare Supplement Open Enrollment take place?
Answer: During the first six months a consumer is 65 or older and
enrolled in Medicare Part B.


◉ What costs count toward the out-of-pocket maximum for
Medicare Advantage (MA) Plans? Answer: The Out-of-Pocket
Maximum includes costs the member pays for any Medicare-covered
Part A or B services but does not include the cost of any plan
premiums.


◉ A consumer currently has Original Medicare and is enrolled in a
stand-alone Prescription Drug Plan (PDP). What will happen if the
consumer enrolls in an MA Plan that has integrated prescription
drug coverage? Answer: The consumer will be automatically
disenrolled from their stand-alone PDP upon enrollment in the MA
Plan that has integrated prescription drug coverage

, ◉ What is Medicare Part D? Answer: A voluntary program, offered
by private insurance companies that are contracted with the federal
government, that provides prescription drug coverage for an
additional monthly plan premium.


◉ Which consumer is eligible for a stand-alone Medicare
Prescription Drug Plan? Answer: Joseph, who is enrolled in Medicare
Part A and Medicare Part B and resides in the plan's service area.


◉ A consumer with only Part A residing in the plan's service area
can enroll in which plan type to get Part D coverage? Answer: A
stand-alone Part D Plan.


◉ Which of the following statements accurately describes a
prescription drug stage? Answer: Starting in 2024, the catastrophic
coverage stage is when the member will pay nothing for covered
drugs for the remainder of the plan year.


◉ Step Therapy, Prior Authorization, Quantity Limit, 7-day limit,
Dispensing Limit and Limited Access are all examples of what?
Answer: Utilization Management Rules


◉ A consumer may have to pay a Late Enrollment Penalty (LEP) 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

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