UHC certification Questions with Correct Answers
Medicare Correct Ans ✓✓ Federal health insurance program
Medicare is administered by whom? Correct Ans ✓✓ CMS ( Centers for
medicare and medicaid services)
Parts A & B of medicare are Correct Ans ✓✓ federal health insurance
program referred to as original medicare
Part A? Correct Ans ✓✓ Hospital insurance
Part B? Correct Ans ✓✓ Medical insurance
What doesnt medicare cover? Correct Ans ✓✓ routine dental, eye care
hearing exam,deductibles, coinsurance and copayments
Part C? Correct Ans ✓✓ Medicare Advantage Plans
MA covers? Correct Ans ✓✓ Part A &B coverage, and some part D
coverage
MA plans are not? Correct Ans ✓✓ Medicare supplement insurance
plans
,What offers lower monthly premiums MADP or supplement? Correct
Ans ✓✓ 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 Ans ✓✓ YES
MA plans integrate what type of additonal coverage? Correct Ans ✓✓
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 Ans ✓✓ MA-only
PFFS plan
What is a stand alone drug plan called? Correct Ans ✓✓ PDP
WHat is PFFS? Correct Ans ✓✓ 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 Ans ✓✓ PFFS plan
Do HMO's require referals? Correct Ans ✓✓ Yes
Do PPO's require a referal? Correct Ans ✓✓ No
, When a member enrolls in a MA plan, they receive their coverage from
medicare or the MA plan? Correct Ans ✓✓ MA plan
When a customer is enrolled in a MA plan, they must continue paying
their premiums for what other plan? Correct Ans ✓✓ Part B
MA plans have a maxium annual limit on OOP costs called a? Correct
Ans ✓✓ 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 Ans ✓✓
effective date
An exception exisits for MA-only PFFS plans as a member can also be
enrolled in a what? Correct Ans ✓✓ Stand alone PDP
If a member enrolls in a MA plan, what must the member do? Correct
Ans ✓✓ Cancel in writing their medicare supplement insurance policy
with the carrier after their request to enroll in MA plan has been
approved.
Medicare supplement insurance policies cannot be used in conjunction
with what type of plan? Correct Ans ✓✓ MA plan
Medicare Correct Ans ✓✓ Federal health insurance program
Medicare is administered by whom? Correct Ans ✓✓ CMS ( Centers for
medicare and medicaid services)
Parts A & B of medicare are Correct Ans ✓✓ federal health insurance
program referred to as original medicare
Part A? Correct Ans ✓✓ Hospital insurance
Part B? Correct Ans ✓✓ Medical insurance
What doesnt medicare cover? Correct Ans ✓✓ routine dental, eye care
hearing exam,deductibles, coinsurance and copayments
Part C? Correct Ans ✓✓ Medicare Advantage Plans
MA covers? Correct Ans ✓✓ Part A &B coverage, and some part D
coverage
MA plans are not? Correct Ans ✓✓ Medicare supplement insurance
plans
,What offers lower monthly premiums MADP or supplement? Correct
Ans ✓✓ 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 Ans ✓✓ YES
MA plans integrate what type of additonal coverage? Correct Ans ✓✓
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 Ans ✓✓ MA-only
PFFS plan
What is a stand alone drug plan called? Correct Ans ✓✓ PDP
WHat is PFFS? Correct Ans ✓✓ 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 Ans ✓✓ PFFS plan
Do HMO's require referals? Correct Ans ✓✓ Yes
Do PPO's require a referal? Correct Ans ✓✓ No
, When a member enrolls in a MA plan, they receive their coverage from
medicare or the MA plan? Correct Ans ✓✓ MA plan
When a customer is enrolled in a MA plan, they must continue paying
their premiums for what other plan? Correct Ans ✓✓ Part B
MA plans have a maxium annual limit on OOP costs called a? Correct
Ans ✓✓ 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 Ans ✓✓
effective date
An exception exisits for MA-only PFFS plans as a member can also be
enrolled in a what? Correct Ans ✓✓ Stand alone PDP
If a member enrolls in a MA plan, what must the member do? Correct
Ans ✓✓ Cancel in writing their medicare supplement insurance policy
with the carrier after their request to enroll in MA plan has been
approved.
Medicare supplement insurance policies cannot be used in conjunction
with what type of plan? Correct Ans ✓✓ MA plan
