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

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QUESTIONS AND ANSWERS 100% bb bb bb bb




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1. Medicare: Federal health insurance program b b bb bb b b




2. Medicare is administered by whom?: CMS ( Centers for medicare and medicaid services)
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3. Parts A& Bof medicareare:federalhealthinsuranceprogramreferredtoasoriginalmedicare
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4. Part A?: Hospital insurance
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5. Part B?: Medical insurance
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6. What doesnt medicare cover?: routine dental, eye care hearing exam,deductibles, coinsurance and
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copayments
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7. Part C?: MedicareAdvantagePlans
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8. MA covers?: Part A &B coverage, and some part D coverage
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9. MA plans are not?: Medicare supplement insuranceplans
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,10. What offers lower monthly premiums MADP or supplement?: MADP bb bb bb bb bb bb bb bb




11. do MAP's have a annual maximum OOP maximum that limits the amount of
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money a member must spend every year for covered services?: YES
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12. MA plans integrate what type of additonal coverage?: partDprescriptiondrugcoverage
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13. If a customer wants to keep their stand alone prescription drug plan,
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bwhat maythe customer wanttoenroll in?:MA-onlyPFFSplan
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14. What is a stand alone drug plan called?: PDP b b b b b b b b b b b b b b b b




15. WHat is PFFS?: PrivateFeeforService(PFFS)-Plansthatallowyoutogotoanydoctororhospitalthatacceptstheir terms
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16. If a customer lives in a rural area, what type of plan may they want because it gives
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themfreedomtoaccessdoctorsthatmaynotbeintheirnetwork?:PFFSplan
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17. Do HMO's require referals?: Yes
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18. Do PPO's require a referal?: No
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19. When a member enrolls in a MA plan, they receive their coverage from bb bb bb bb bb bb bb bb bb bb bb bb




medicare orthe MAplan?: MAplan
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20. When a customer is enrolled in a MA plan, they must continue paying their bb bb bb bb bb bb bb bb bb bb bb bb bb




premiums for what other plan?: PartB
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21. MAplanshaveamaxiumannuallimitonOOPcostscalleda?:MOOPamount(
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Maxium out of pocket)
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, 22. When a member is enrolled in a MA plan, they are automatically b b b b b b b b b b b b b b b b b b b b b b




disenrolled from any other MA plan or PDP( prescription drug plan) in
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which they are enrolled as of the new plans
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23. An exception exisits for MA-only PFFS plans as a member can also be enrolled
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in awhat?:StandalonePDP
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24. If a member enrolls in a MA plan, what must the member do?:
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Cancel in writing their medicaresupplementinsurancepolicywiththecarrieraftertheirrequesttoenrollinMAplanhas
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beenapproved.
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25. Medicare supplement insurance policies cannot be used in conjunction with bb bb bb bb bb bb bb bb bb




whattypeofplan?:MAplan
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26. A medicare supplement insurance plan helps to cover some of the OOP costs
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associated with?: originalmedicare.
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27. A medicare supplement insurance plan does NOT pay the cost-sharing of
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whattypeofplan?:MAplan
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28. when a client enrolls in a MA plan, will it automatically terminate their MA bb bb bb bb bb bb bb bb bb bb bb bb b b




plan?: NO bb bb




29. Can a customer call to terminate their Med Sup plan?: noitmustbedoneinwriting
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30. What are the different types of MA plans?: HMO,POS,PPO, RPPO,PFFS,SNP,andMSA
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31. For an HMO, they customer must us IN network providers, what
are the exceptions to their rule?: Emergencies, Urgent care,andrenal dialysis services.
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