UHC certification test Q&A.
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
An exception exisits for MA-only PFFS plans as a member can also be
enrolled in a what? ~CORRECT ANSWER~✓✓Stand alone PDP
If a member enrolls in a MA plan, what must the member do? ~CORRECT
ANSWER~✓✓Cancel in writing their medicare supplement insurance
policy with the carrier after their request to enroll in MA plan has been
approved.
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
An exception exisits for MA-only PFFS plans as a member can also be
enrolled in a what? ~CORRECT ANSWER~✓✓Stand alone PDP
If a member enrolls in a MA plan, what must the member do? ~CORRECT
ANSWER~✓✓Cancel in writing their medicare supplement insurance
policy with the carrier after their request to enroll in MA plan has been
approved.
