UHC CERTIFICATION EXAM QUESTIONS AND
1. 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
ANS >>> - Part A
2. : The consumer must be in a valid MA election or disenrollment period.
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, 3. Which of the following consumers would be eligible for Medicare ANS >>>
Con- sumers age 65 or older, consumers under 65 years of age with certain
disabilities for more than 24 months and consumers of all ages with ESRD or
ALS
4. Which of the following defines a Medicare Advantage (MA) Plan ANS >>> MA
Plans are health plan options approved by Medicare and offered by private
insurance companies.
5. Janice wants to enroll in a 2021 Medicare Advantage plan. What eligibility
requirements must she meet? (Select the two answers that apply.): Not have
End Stage Renal Disease (permanent kidney failure)Reside in the plan's service
area
6. What must be explained to consumers enrolling in an HMO (Health Mainte-
nance Organization) MA Plan? (Select 3):
7. Which of the following are MA Plans that focus on using network providers
to maximize the benefits and reduce out-of-network expenses ANS >>> HMO,
POS, PPO
8. Which is true about Medicare Supplement Open Enrollment ANS >>> By
federal law, Medicare Supplement Open Enrollment is the first 6 months a
consumer is 65 or older and enrolled in Medicare Part B.
9. How does the Medicare Advantage Out-of-Pocket (OOP) maximum work?-
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, : 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.
10. 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 ANS >>>
The consumer will be automatically disenrolled from their stand-alone PDP upon
enroll- ment in the MA Plan that has integrated prescription drug coverage
11. A government program, offered only through a private insurance company
or other private company approved by Medicare, that provides prescription
drug coverage describes which of the following:: Medicare Parts A and B
12. Which of the following statements is true about eligibility requirements for
Medicare Prescription Drug Plans ANS >>> A consumer must be entitled to
Medicare Part A and/or enrolled in Medicare Part B
13. What are two options for Medicare consumers to get Part D prescription
drug coverage (assuming they meet all eligibility requirements)? (Select 2):
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1. 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
ANS >>> - Part A
2. : The consumer must be in a valid MA election or disenrollment period.
https://www.stuvia.com/user/CULTIVATED 1/
20
, 3. Which of the following consumers would be eligible for Medicare ANS >>>
Con- sumers age 65 or older, consumers under 65 years of age with certain
disabilities for more than 24 months and consumers of all ages with ESRD or
ALS
4. Which of the following defines a Medicare Advantage (MA) Plan ANS >>> MA
Plans are health plan options approved by Medicare and offered by private
insurance companies.
5. Janice wants to enroll in a 2021 Medicare Advantage plan. What eligibility
requirements must she meet? (Select the two answers that apply.): Not have
End Stage Renal Disease (permanent kidney failure)Reside in the plan's service
area
6. What must be explained to consumers enrolling in an HMO (Health Mainte-
nance Organization) MA Plan? (Select 3):
7. Which of the following are MA Plans that focus on using network providers
to maximize the benefits and reduce out-of-network expenses ANS >>> HMO,
POS, PPO
8. Which is true about Medicare Supplement Open Enrollment ANS >>> By
federal law, Medicare Supplement Open Enrollment is the first 6 months a
consumer is 65 or older and enrolled in Medicare Part B.
9. How does the Medicare Advantage Out-of-Pocket (OOP) maximum work?-
https://www.stuvia.com/user/CULTIVATED 2/
20
, : 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.
10. 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 ANS >>>
The consumer will be automatically disenrolled from their stand-alone PDP upon
enroll- ment in the MA Plan that has integrated prescription drug coverage
11. A government program, offered only through a private insurance company
or other private company approved by Medicare, that provides prescription
drug coverage describes which of the following:: Medicare Parts A and B
12. Which of the following statements is true about eligibility requirements for
Medicare Prescription Drug Plans ANS >>> A consumer must be entitled to
Medicare Part A and/or enrolled in Medicare Part B
13. What are two options for Medicare consumers to get Part D prescription
drug coverage (assuming they meet all eligibility requirements)? (Select 2):
https://www.stuvia.com/user/CULTIVATED 3/
20
