UHC Medicare Basics Test 2023

UHC Medicare Basics Test 2023 Joseph has Original Medicare and was a patient in the hospital last week. What part of Medicare helps cover the costs of his inpatient hospital stay? Answer Part A Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan? Answer The consumer must be in a valid MA election or disenrollment period. 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 MA Plans must provide benefits equivalent to Original Medicare, and most plans also offer additional benefits. & MA Plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage. Larry wants to enroll in a 2021 Medicare Advantage plan. He has End Stage Renal Disease (permanent kidney failure). What eligibility requirements must he meet? (Select the two answers that apply.) Answer Reside in the plan's service area & Entitled to Medicare Part A and enrolled in Part B Member Doug enrolled in a Health Maintenance Organization (HMO) MA Plan. He saw an out-of-network doctor and received a bill for the entire cost of the visit. Doug called Medicare to complain and stated he was never told about these types of costs. What should the agent have explained better to Doug when he was enrolling in the plan? (Select 3) Answer That Doug must receive covered services from contracted network providers. & That exceptions to the provider network requirement are emergency visits, urgent care and renal dialysis services, which can be obtained from out-of-network providers. & That in most cases, Doug will pay the entire cost of the service if he sees an out-of-network provider. Which of the following is not a correct statement about in-network provider services? Answer Which is true about Medicare Supplement Open Enrollment? Answer By federal law, Medicare Supplement Open Enrollment is the first 6 months a consumer is 65 or older and enrolled in Medicare Part B. How does the Medicare Advantage Out-of-Pocket (OOP) maximum work? Answer The OOP maximum is a feature that limits the amount of money a consumer will have to spend on Medicare-covered health care services each year. 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 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 statements is true about eligibility requirements for Medicare Prescription Drug Plans? Answer A consumer must be entitled to Medicare Part A and/or enrolled in Medicare Part B Aside from a stand-alone Medicare Prescription Drug Plan, how else could a Medicare-eligible consumer get Part D prescription drug coverage? Answer They could enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverage. In what order do the four prescription drug coverage stages occur? Answer Deductible, Initial Coverage, Coverage Gap, Catastrophic Coverage Which of the following options are drug utilization management (UM) rules? (Select 3) Answer Quantity Limit Prior Authorization Step Therapy 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 prescription drug coverage for ______________. Answer 63 continuous days or more How does a consumer who qualifies for Low Income Subsidy receive financial assistance for their part of Medicare Part D costs? Answer Through subsidies such as lower or no monthly plan premiums and lower