UHC certification Exam 2025/2026
QUESTIONS AND ANSWERS 100%
PASS.
1. Medicare: Federal health insurance program 7 q 7q 7q 7q
2. Medicare is administered by whom?: CMS ( Centers for medicare and medicaid services)
7 q 7 q 7 q 7 q 7 q 7q 7q 7q 7q 7q 7q 7q
3. Parts A & B of medicare are: federal healthinsurance program referred toasoriginal medicare
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
4. Part A?: Hospital insurance
7q 7q 7q
5. Part B?: Medical insurance
7 q 7 q 7q
6. What doesnt medicare cover?: routine dental, eye care hearing exam,deductibles, coinsurance and
7 q 7 q 7 q 7 q 7q 7q 7q 7q 7q 7q 7q
copayments
7q
7. Part C?: Medicare Advantage Plans
7q 7 q 7q 7q
8. MA covers?: Part A &B coverage, and some part D coverage
7 q 7 q 7q 7q 7q 7q 7q 7q 7q 7q
9. MA plans are not?: Medicare supplement insurance plans
7q 7q 7 q 7 q 7q 7q 7q
,10. What offers lower monthly premiums MADP or supplement?: MADP
7q 7q 7q 7q 7q 7q 7q 7q
11. do MAP's have a annual maximum OOP maximum that limits the amount of
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
money a member must spend every year for covered services?: YES
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
12. MA plans integrate what type of additonal coverage?: partDprescriptiondrugcoverage
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
13. If a customer wants to keep their stand alone prescription drug plan,
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
what may the customer want to enroll in?: MA-onlyPFFSplan
7 q 7q 7q 7q 7q 7q 7q 7q 7q q
7 q
7
14. What is a stand alone drug plan called?: PDP7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
15. WHat is PFFS?: PrivateFeeforService (PFFS)- Plans that allow you to go to anydoctor orhospital thataccepts their terms
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
16. If a customer lives in a rural area, what type of plan may they want because it
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
givesthem freedom to access doctors thatmaynot be in theirnetwork?: PFFS plan
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
17. Do HMO's require referals?: Yes
7 q 7 q 7 q 7 q
18. Do PPO's require a referal?: No
7q 7q 7q 7q 7q
19. When a member enrolls in a MA plan, they receive their coverage from
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
medicare or the MA plan?: MAplan
7q 7q 7q 7q 7q 7q q
7
20. When a customer is enrolled in a MA plan, they must continue paying their
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
premiums for what other plan?: PartB
7q 7q 7q 7q 7q 7q 7q
21. MAplanshave amaxium annual limit onOOP costscalled a?: MOOPamount(
q
7 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
Maxium out of pocket)
7q 7q 7q 7q
, 22. When a member is enrolled in a MA plan, they are automatically 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
disenrolled from any other MA plan or PDP( prescription drug plan) in
7 q 7q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
which they are enrolled as of the new plans ?:ettective date
7 q 7 q 7 q 7 q 7 q 7q 7q 7q 7q 7q 7q
23. An exception exisits for MA-only PFFS plans as a member can also be enrolled
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
in a what?: StandalonePDP
7 q 7q 7q 7q
24. If a member enrolls in a MA plan, what must the member do?:
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
Cancel in writing their medicare supplementinsurance policy with the carrier after their request toenroll in MA plan has
7 q 7 q 7 q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
been approved.
7q 7q
25. Medicare supplement insurance policies cannot be used in conjunction with 7q 7q 7q 7q 7q 7q 7q 7q 7q
whattype ofplan?: MAplan
7 q 7q 7q 7q 7q
26. A medicare supplement insurance plan helps to cover some of the OOP costs
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
associated with?: originalmedicare.
7 q 7q 7q
27. A medicare supplement insurance plan does NOT pay the cost-sharing of
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
whattype ofplan?: MAplan
7q 7q 7q 7q 7q
28. when a client enrolls in a MA plan, will it automatically terminate their 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
MA plan?: NO
7 q 7q 7q
29. Can a customer call to terminate their Med Sup plan?: noitmustbedoneinwriting
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
30. What are the different types of MA plans?: HMO,POS,PPO, RPPO,PFFS,SNP,andMSA
jy 7 q 7 q 7 q 7 q 7 q 7 q 7 q jy
31. For an HMO, they customer must us IN network providers, what
are the exceptions to their rule?: Emergencies, Urgent care, and renal dialysis services.
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
QUESTIONS AND ANSWERS 100%
PASS.
1. Medicare: Federal health insurance program 7 q 7q 7q 7q
2. Medicare is administered by whom?: CMS ( Centers for medicare and medicaid services)
7 q 7 q 7 q 7 q 7 q 7q 7q 7q 7q 7q 7q 7q
3. Parts A & B of medicare are: federal healthinsurance program referred toasoriginal medicare
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
4. Part A?: Hospital insurance
7q 7q 7q
5. Part B?: Medical insurance
7 q 7 q 7q
6. What doesnt medicare cover?: routine dental, eye care hearing exam,deductibles, coinsurance and
7 q 7 q 7 q 7 q 7q 7q 7q 7q 7q 7q 7q
copayments
7q
7. Part C?: Medicare Advantage Plans
7q 7 q 7q 7q
8. MA covers?: Part A &B coverage, and some part D coverage
7 q 7 q 7q 7q 7q 7q 7q 7q 7q 7q
9. MA plans are not?: Medicare supplement insurance plans
7q 7q 7 q 7 q 7q 7q 7q
,10. What offers lower monthly premiums MADP or supplement?: MADP
7q 7q 7q 7q 7q 7q 7q 7q
11. do MAP's have a annual maximum OOP maximum that limits the amount of
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
money a member must spend every year for covered services?: YES
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
12. MA plans integrate what type of additonal coverage?: partDprescriptiondrugcoverage
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
13. If a customer wants to keep their stand alone prescription drug plan,
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
what may the customer want to enroll in?: MA-onlyPFFSplan
7 q 7q 7q 7q 7q 7q 7q 7q 7q q
7 q
7
14. What is a stand alone drug plan called?: PDP7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
15. WHat is PFFS?: PrivateFeeforService (PFFS)- Plans that allow you to go to anydoctor orhospital thataccepts their terms
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
16. If a customer lives in a rural area, what type of plan may they want because it
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
givesthem freedom to access doctors thatmaynot be in theirnetwork?: PFFS plan
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
17. Do HMO's require referals?: Yes
7 q 7 q 7 q 7 q
18. Do PPO's require a referal?: No
7q 7q 7q 7q 7q
19. When a member enrolls in a MA plan, they receive their coverage from
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
medicare or the MA plan?: MAplan
7q 7q 7q 7q 7q 7q q
7
20. When a customer is enrolled in a MA plan, they must continue paying their
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
premiums for what other plan?: PartB
7q 7q 7q 7q 7q 7q 7q
21. MAplanshave amaxium annual limit onOOP costscalled a?: MOOPamount(
q
7 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
Maxium out of pocket)
7q 7q 7q 7q
, 22. When a member is enrolled in a MA plan, they are automatically 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
disenrolled from any other MA plan or PDP( prescription drug plan) in
7 q 7q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
which they are enrolled as of the new plans ?:ettective date
7 q 7 q 7 q 7 q 7 q 7q 7q 7q 7q 7q 7q
23. An exception exisits for MA-only PFFS plans as a member can also be enrolled
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
in a what?: StandalonePDP
7 q 7q 7q 7q
24. If a member enrolls in a MA plan, what must the member do?:
7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q 7 q
Cancel in writing their medicare supplementinsurance policy with the carrier after their request toenroll in MA plan has
7 q 7 q 7 q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
been approved.
7q 7q
25. Medicare supplement insurance policies cannot be used in conjunction with 7q 7q 7q 7q 7q 7q 7q 7q 7q
whattype ofplan?: MAplan
7 q 7q 7q 7q 7q
26. A medicare supplement insurance plan helps to cover some of the OOP costs
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
associated with?: originalmedicare.
7 q 7q 7q
27. A medicare supplement insurance plan does NOT pay the cost-sharing of
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
whattype ofplan?: MAplan
7q 7q 7q 7q 7q
28. when a client enrolls in a MA plan, will it automatically terminate their 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
MA plan?: NO
7 q 7q 7q
29. Can a customer call to terminate their Med Sup plan?: noitmustbedoneinwriting
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q
30. What are the different types of MA plans?: HMO,POS,PPO, RPPO,PFFS,SNP,andMSA
jy 7 q 7 q 7 q 7 q 7 q 7 q 7 q jy
31. For an HMO, they customer must us IN network providers, what
are the exceptions to their rule?: Emergencies, Urgent care, and renal dialysis services.
7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q 7q