2025/2026 UPDATED UHC MEDICARE BASICS EXAM, QUESTIONS WITH ACCURATE ANSWERS | MULTIPLE CHOICES A+ GRADED

2025/2026 UPDATED UHC MEDICARE BASICS EXAM, QUESTIONS WITH ACCURATE ANSWERS | MULTIPLE CHOICES A+ GRADED 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