UHC Certification 2023/2024 Questions With
Complete Solutions
Which statement is true about the Medicare Advantage (MA) Out- of pocket Maximum? correct answer: All MA plans have an Out- of Pocket maximum to help limit the member's out of pocket cost for Medicare-covered services.
A consumer currently has Original Medicare and is enrolled in a
stand alone PDP. What will happens if the consumer enrolls in a
n MA Plan that has integrated PDP coverage? correct answer: The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in the MA Plan has integrated prescription drug coverage.
What is Medicare Part D? correct answer: A voluntary program,
offered by private insurance companies that are contracted with the federal government, that provide prescription drug coverage for an additional monthly plan premium.
Which of the following statement is true about eligibility requirement for stand alone Medicare prescription drug plans? correct answer: A consumer must be entitled to Medicare Part A/ or enrolled in Medicare Part B
Aside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage, how else could a Medicare-
eligible consumer get Part D PDP ? correct answer: They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP) In what order do they four prescription drug coverage stages occur? correct answer: Deductible, Initial coverage, coverage gap, catastrophic coverage
Step Therapy, prior authorization, quantity limit 7-day limit, dispensing limit and limited access are all examples of what? correct answer: Which of the following best describes the Late Enrollment Penalty (LEP)? correct answer: The amount added to the member's monthly plan premium if they did not enroll in a Medicare advantage plan with part d benefits or stand alone PDP
when they are first eligible Medicare Part and B or went without
creditable coverage for 63 days or more days
Through which means if financial assistance offered to a consumer who qualifies for a LIS for their parts of Medicare part D costs? correct answer: Through subsidies such as lower or no monthly plan premiums and lower or no copayments
Which of the following list drug tiers from least expensive cost share to most expensive cost shares correct answer: In states where Medicare Supplements Insurance underwriting criteria can apply, all of the following underwriting criteria apply EXCEPT: correct answer: Lisa turned 65 and is now eligible for Medicare. She already received Social Security benefits. How does she enroll in original Medicare? correct answer: Hern enrollment in
Complete Solutions
Which statement is true about the Medicare Advantage (MA) Out- of pocket Maximum? correct answer: All MA plans have an Out- of Pocket maximum to help limit the member's out of pocket cost for Medicare-covered services.
A consumer currently has Original Medicare and is enrolled in a
stand alone PDP. What will happens if the consumer enrolls in a
n MA Plan that has integrated PDP coverage? correct answer: The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in the MA Plan has integrated prescription drug coverage.
What is Medicare Part D? correct answer: A voluntary program,
offered by private insurance companies that are contracted with the federal government, that provide prescription drug coverage for an additional monthly plan premium.
Which of the following statement is true about eligibility requirement for stand alone Medicare prescription drug plans? correct answer: A consumer must be entitled to Medicare Part A/ or enrolled in Medicare Part B
Aside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage, how else could a Medicare-
eligible consumer get Part D PDP ? correct answer: They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP) In what order do they four prescription drug coverage stages occur? correct answer: Deductible, Initial coverage, coverage gap, catastrophic coverage
Step Therapy, prior authorization, quantity limit 7-day limit, dispensing limit and limited access are all examples of what? correct answer: Which of the following best describes the Late Enrollment Penalty (LEP)? correct answer: The amount added to the member's monthly plan premium if they did not enroll in a Medicare advantage plan with part d benefits or stand alone PDP
when they are first eligible Medicare Part and B or went without
creditable coverage for 63 days or more days
Through which means if financial assistance offered to a consumer who qualifies for a LIS for their parts of Medicare part D costs? correct answer: Through subsidies such as lower or no monthly plan premiums and lower or no copayments
Which of the following list drug tiers from least expensive cost share to most expensive cost shares correct answer: In states where Medicare Supplements Insurance underwriting criteria can apply, all of the following underwriting criteria apply EXCEPT: correct answer: Lisa turned 65 and is now eligible for Medicare. She already received Social Security benefits. How does she enroll in original Medicare? correct answer: Hern enrollment in
