UHC 2027 CERTB QUESTIONS AND ANSWERS

UHC 2027 CERTB QUESTIONS AND
ANSWERS
Miltontistretiringtonthist65thtbirthday.tHetisteligibletfortMedicaretandtalreadytgetstSocial
tSecuritytbenefits.tHowtdoesthetenrolltintOriginaltMedicare?
-tHetmusttenrolltintMedicaretPartstAtandtBtthroughthistcurrenttortformertemployer.
-
tHistenrollmenttintMedicaretPartstAtandtBtistgenerallytautomatictifthetmeetstallteligibilit
ytrequirements.
-tHetcantonlytsigntuptfortMedicaretPartstAtand/ortBtatthistlocaltSocialtSecuritytoffice.
-tHetcantsigntuptfortMedicaretPartstAtand/ortBtwithtanytlicensedtinsurancetagent.t-
tans-
HistenrollmenttintMedicaretPartstAtandtBtistgenerallytautomatictifthetmeetstallteligibility
trequirements.

IftatconsumertcurrentlythastatMedicaretAdvantagetplantandtwantstatMedicaretSupplem
enttPlant,twhichtstatementtistcorrect?
-tTheytcanthavetbothtplanstattthetsamettimetfortextratcoverage.
-tEnrollingtintatMedicaretSupplementtPlantautomaticallytcancelsttheirtMAtplan.
-tTheytmusttdisenrolltfromtthetMAtplantduringtatvalidtelectiontperiod.
-tTheytcantonlytswitchtduringtthetAnnualtElectiontPeriodt(Octt15-Dect7).t-tans-
TheytmusttdisenrolltfromtthetMAtplantduringtatvalidtelectiontperiod.

Beingt65tortolder,tortbeingtundert65twithtatqualifyingtdisability,tortbeingtanytagetwithtE
nd-
StagetRenaltDiseaset(ESRD)tortAmyotrophictLateraltSclerosist(ALS)tareteligibilitytrequi
rementstfortwhichtprogram?
-tMedicaid
-tLowtIncometSubsidy
-tOriginaltMedicaret-tans-OriginaltMedicare

WhichtoftthetfollowingtstatementstdescribetatMedicaretAdvantaget(MA)tplan?t(selectt3)
-
tMAtplanstaretofferedtbytprivatetinsurancetcompaniestandtapprovedtandtcontractedtbyt
thetfederaltgovernment.
-
tMAtplanstmusttprovidetattleasttthetsametcoveragetastOriginaltMedicaretandtoftentinclu
detadditionaltbenefitstliketprescriptiontdrugtcoveraget(ParttD)tandtmore.
-tMAtplanstaretparttoftMedicaretandtalsotreferredttotastParttC.
-tMAtplanstdotNOTthavettotprovidetattleasttthetsametcoveragetastOriginaltMedicare.t-
tans--
tMAtplanstaretofferedtbytprivatetinsurancetcompaniestandtapprovedtandtcontractedtbyt
thetfederaltgovernment.

,-
tMAtplanstmusttprovidetattleasttthetsametcoveragetastOriginaltMedicaretandtoftentinclu
detadditionaltbenefitstliketprescriptiontdrugtcoveraget(ParttD)tandtmore.
-tMAtplanstaretparttoftMedicaretandtalsotreferredttotastParttC.

WhichtoftthetfollowingtareteligibilitytrequirementsttotenrolltintatMedicaretAdvantagetplan
?t(Selectt3)
-tIstenrolledtintMedicaretParttB
-tDoestnotthavetanytpre-
existingtconditionstsuchtastdiabetestortEndtStagetRenaltDiseaset(ESRD)
-tLivestintthetplan'stservicetarea
-tIstentitledttotMedicaretParttAt-tans--tIstenrolledtintMedicaretParttB
-tLivestintthetplan'stservicetarea
-tIstentitledttotMedicaretParttA

Whichtoftthetfollowingtistatcorrecttstatementtabouttnetworktprovidertservices?
-tPoint-of-Servicet(POS)tplanstmusttcovertthetsametbenefitstout-of-
networktthatttheytcovertin-network.
-tPreferredtProvidertOrganizationt(PPO)tplanstcantchosettotcovertselecttbenefitstout-of-
network.
-tHealthtMaintenancetOrganizationt(HMO)tplanstgenerallytcovertonlytin-
networktservices.tIntmosttcases,tmemberstpaytthetfulltcosttoftanytout-of-
networktservicestreceived,twithtatfewtimportanttexceptions.t-tans--
tHealthtMaintenancetOrganizationt(HMO)tplanstgenerallytcovertonlytin-
networktservices.tIntmosttcases,tmemberstpaytthetfulltcosttoftanytout-of-
networktservicestreceived,twithtatfewtimportanttexceptions.

WhichttypetoftMAtplantistantHMOtplantthattalsotcoverstcertaintbenefitstout-of-
network,tgenerallytattathighertcost?
-tPoint-of-Servicet(POS)tplan
-tParttDtplantMedicaretSupplementtPlan
-tPrivatetFee-for-Servicet(PFFS)t-tans--tPoint-of-Servicet(POS)tplan

WhichtstatementtcorrectlytdescribestthetMedicaretSupplementtOpentEnrollmenttPeriod
?
-tIttbeginst3tmonthstbeforetthetconsumer'st65thtbirthdaytandtendst3tmonthstafter.
-tIttoccurstannuallytduringtthetMedicaretAdvantagetOpentEnrollmenttPeriod.
-tIttlastst3tmonthstandtbeginstwhentthetconsumertenrollstintMedicaretParttAtandtB.
-
tIttlastst6tmonthstandtbeginstwhentthetconsumertist65tortoldertandtenrolledtintMedicar
etParttB.t-tans--
tIttlastst6tmonthstandtbeginstwhentthetconsumertist65tortoldertandtenrolledtintMedicar
etParttB.

JennifertistenrollingtintantMAtplantandtwantsttotknowtwhattcountsttowardtthetmedicalta
nnualtout-of-pockettmaximum.tWhichtoftthetfollowingtistaccurate?

, -tThetmedicaltannualtout-of-
pockettmaximumtincludestanytcoststshetpaysttowardtthetplan,tsuchtastplantpremiumst
andtParttDtout-of-pockettcost-sharing.
-tHertout-of-pockettmaximumtincludestwhattshetpaystfortMedicare-
coveredtParttAtandtParttBtservices,tbuttittdoestnottincludetanytplantpremiums.
-tAlltout-of-
pockettcoststshetpaysttowardtherthealthtcaretandtParttDtprescriptiontdrugtexpensestwo
uldtcountttowardtthetmedicaltannualtout-of-pockettmaximum.t-tans--tHertout-of-
pockettmaximumtincludestwhattshetpaystfortMedicare-
coveredtParttAtandtParttBtservices,tbuttittdoestnottincludetanytplantpremiums.

AtconsumertcurrentlythastOriginaltMedicaretandtistenrolledtintatstandalonetPrescription
tDrugtPlant(PDP).tWhattwillthappentiftthetconsumertenrollstintantMAtplantthattincludest
prescriptiontdrugtcoverage?
-
tThetconsumertwilltbetautomaticallytdisenrolledtfromttheirtstandalonetPDPtaftertenrollin
gtintthetMAtplantthatthastintegratedtprescriptiontdrugtcoverage.
-
tThetconsumertwilltnotlongertbetatparttoftthetMedicaretprogramtbecausettheytwilltgettth
eirtmedicaltandthospitaltbenefitstcoveredtbytthetMAtplan.
-
tThetconsumer'stMAtplantenrollmenttapplicationtwilltbetdeniedtbecausettheytalreadytha
vetatstandalonetPDP.t-tans--
tThetconsumertwilltbetautomaticallytdisenrolledtfromttheirtstandalonetPDPtaftertenrollin
gtintthetMAtplantthatthastintegratedtprescriptiontdrugtcoverage.

WhattistMedicaretParttD?
-
tAtvoluntarytprogram,tofferedtbytprivatetinsurancetcompaniestthattaretcontractedtwithtt
hetfederaltgovernment,tthattprovidestprescriptiontdrugtcoveragetfortantadditionaltmonth
lytplantpremium.
-
tAtprogramtthattistautomaticallytavailablettotallteligibletconsumerstattnotadditionaltchar
ge.
-tAntinvoluntarytprogramtthattrequirestantadditionaltmonthlytpremium.
-
tAtprivatethealthtplantoptiontthattprovidestcatastrophicthospitaltcoveragetfortconsumers
twhotaretenrolledtintbothtMedicaretParttAtandtMedicaretParttB.t-tans--
tAtvoluntarytprogram,tofferedtbytprivatetinsurancetcompaniestthattaretcontractedtwithtt
hetfederaltgovernment,tthattprovidestprescriptiontdrugtcoveragetfortantadditionaltmonth
lytplantpremium.

WhichtconsumertisteligibletfortatstandalonetMedicaretPrescriptiontDrugtPlant(PDP)?
-
tAlvin,twhotistenrolledtonlytintMedicaretParttB,tbuttdoestnottlivetintthetplan'stservicetare
a.