UHC Certification Review Practice Test.

UHC Certification Review Practice Test. Medicare - CORRECT ANSWER Federal health insurance program Medicare is administered by whom? - CORRECT ANSWER CMS ( Centers for medicare and medicaid services) Parts A & B of medicare are - CORRECT ANSWER federal health insurance program referred to as original medicare Part A? - CORRECT ANSWER Hospital insurance Part B? - CORRECT ANSWER Medical insurance What doesnt medicare cover? - CORRECT ANSWER routine dental, eye care hearing exam,deductibles, coinsurance and copayments Part C? - CORRECT ANSWER Medicare Advantage Plans MA covers? - CORRECT ANSWER Part A &B coverage, and some part D coverage MA plans are not? - CORRECT ANSWER Medicare supplement insurance plans What offers lower monthly premiums MADP or supplement? - CORRECT ANSWER MADP do MAP's have a annual maximum OOP maximum that limits the amount of money a member must spend every year for covered services? - CORRECT ANSWER YES MA plans integrate what type of additonal coverage? - CORRECT ANSWER part D prescription drug coverage If a customer wants to keep their stand alone prescription drug plan, what may the customer want to enroll in? - CORRECT ANSWER MA-only PFFS plan What is a stand alone drug plan called? - CORRECT ANSWER PDP WHat is PFFS? - CORRECT ANSWER Private Fee for Service (PFFS) - Plans that allow you to go to any doctor or hospital that accepts their terms If a customer lives in a rural area, what type of plan may they want because it gives them freedom to access doctors that may not be in their network? - CORRECT ANSWER PFFS plan Do HMO's require referals? - CORRECT ANSWER Yes Do PPO's require a referal? - CORRECT ANSWER No When a member enrolls in a MA plan, they receive their coverage from medicare or the MA plan? - CORRECT ANSWER MA plan When a customer is enrolled in a MA plan, they must continue paying their premiums for what other plan? - CORRECT ANSWER Part B MA plans have a maxium annual limit on OOP costs called a? - CORRECT ANSWER MOOP amount ( Maxium out of pocket) When a member is enrolled in a MA plan, they are automatically disenrolled from any other MA plan or PDP( prescription drug plan) in which they are enrolled as of the new plans_____? - CORRECT ANSWER effective date