2023 Uhc Certifications 94 Questionswith Complete Solutions

Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? Correct Answer: Herenrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements. Which statement is true about a member of a Medicare Advantage (MA) Plan whowants to enroll in a Medicare Supplement Insurance Plan? Correct Answer: Whena 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 morethan 24 months, and being any age with ESRD or ALS are each eligibility requirements for which program? Correct Answer: Original Medicare Which of the following defines a Medicare Advantage (MA) Plan? (Select 2)Correct 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 includeMedicare prescription drug coverage. Which of the following is NOT an eligibility requirement for enrollment in aMedicare Advantage Plan? Correct Answer: Does not have any pre-existingconditions such as diabetes or End Stage Renal Disease (ESRD) Which of the following statements is correct about HMO MA Plans? CorrectAnswer: 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? Correct Answer: (INCORRECT) Network-based MA plans have a provider network the member canuse, and some plans also cover certain servicesoutside the network. What is true about Medicare supplement open enrollment? Correct Answer: (INCORRECT) A consumer who waits to enroll in Medicare Part B until age 66 orolder cannot qualify for Medicare Supplement Open Enrollment. (INCORRECT) It is the only time a consumer is eligible to purchase a MedicareSupplement 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? Correct Answer: The Out-of-Pocket Maximum will include her coststoward any Medicare-covered Part A or B services. Which of the following statements is true about a Medicare Supplement InsurancePlan member who wants to enroll in an MA Plan? Correct 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? Correct Answer: It is a government program, offered only through a private insurance company or otherprivate company approved by Medicare, which provides prescription drug coverage. Which of the following is a fact about Medicare Prescription Drug Plans? CorrectAnswer: To enroll, member must be in plans service area What are two options for Medicare consumers to get Part D prescription drugcoverage (assuming they meet all eligibility requirements)? (Select 2) CorrectAnswer: Enroll in a stand-alone Medicare Prescription Drug Plan (PDP) Enroll in a Medicare Advantage Plan or other Medicare health plan that includesprescription drug coverage Which of the following statements does NOT correctly define prescription drugstages? Correct