UHC certification Exam 2025/2026 QUESTIONS AND ANSWERS 100% PASS.

UHC certification Exam 2025/2026
QUESTIONS AND ANSWERS 100%
PASS.




1. Medicare: Federal health insurance program

2. Medicare is administered by whom?: CMS ( Centers for medicare and medicaid services)

3. Parts A & B of medicare are: federal health insurance program referred to as original medicare

4. Part A?: Hospital insurance

5. Part B?: Medical insurance

6. What doesnt medicare cover?: routine dental, eye care hearing exam,deductibles, coinsurance and
copayments

7. Part C?: Medicare Advantage Plans

8. MA covers?: Part A &B coverage, and some part D coverage

9. MA plans are not?: Medicare supplement insurance plans

,10. What offers lower monthly premiums MADP or supplement?: MADP

11. do MAP's have a annual maximum OOP maximum that limits the amount of
money a member must spend every year for covered services?: YES

12. MA plans integrate what type of additonal coverage?: part D prescription drug coverage

13. If a customer wants to keep their stand alone prescription drug plan, what
may the customer want to enroll in?: MA-only PFFS plan

14. What is a stand alone drug plan called?: PDP

15. WHat is PFFS?: Private Fee for Service (PFFS) - Plans that allow you to go to any doctor or hospital that accepts their
terms

16. 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?: PFFS plan

17. Do HMO's require referals?: Yes

18. Do PPO's require a referal?: No

19. When a member enrolls in a MA plan, they receive their coverage from
medicare or the MA plan?: MA plan

20. When a customer is enrolled in a MA plan, they must continue paying their
premiums for what other plan?: Part B

21. MA plans have a maxium annual limit on OOP costs called a?: MOOP amount (
jy jy jy jy jy jy jy jy jy jy jy jy jy jy



Maxium out of pocket)
jy jy jy jy

, 22. When a member is enrolled in a MA plan, they are automatically disenrolled
jy jy jy jy jy jy jy jy jy jy jy jy



from any other MA plan or PDP( prescription drug plan) in which they are
jy jy jy jy jy jy jy jy jy jy jy jy jy jy



enrolled as of the new plans
jy ?: ettective date jy jy jy jy jy jy jy




23. An exception exisits for MA-only PFFS plans as a member can also be enrolled in
jy jy jy jy jy jy jy jy jy jy jy jy jy jy



a what?: Stand alone PDP
jy jy jy jy jy




24. If a member enrolls in a MA plan, what must the member do?: Cancel in writing
jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy



their medicare supplement insurance policy with the carrier after their request to enroll in MA plan has been approved.
jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy




25. Medicare supplement insurance policies cannot be used in conjunction with
jy jy jy jy jy jy jy jy jy



what type of plan?: MA plan
jy jy jy jy jy jy




26. A medicare supplement insurance plan helps to cover some of the OOP costs
jy jy jy jy jy jy jy jy jy jy jy jy



associated with?: original medicare.
jy jy jy jy




27. A medicare supplement insurance plan does NOT pay the cost-sharing of
jy jy jy jy jy jy jy jy jy jy



what type of plan?: MA plan
jy jy jy jy jy jy




28. when a client enrolls in a MA plan, will it automatically terminate their
jy jy jy jy jy jy jy jy jy jy jy jy



MA plan?: NO
jy jy jy




29. Can a customer call to terminate their Med Sup plan?: no it must be done in writing
jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy




30. What are the different types of MA plans?: HMO, POS, PPO, RPPO, PFFS, SNP, and MSA
jy jy jy jy jy jy jy jy jy jy jy jy jy jy jy




31. For an HMO, they customer must us IN network providers, what
j y j y j y j y j y j y j y j y j y j y



are the exceptions to their rule?: Emergencies, Urgent care, and renal dialysis services.
j y j y jy jy jy jy jy jy jy jy jy jy jy