2025 UHC Fast Track assessment Mastery Test Question and Answer 2025/2026

2025 UHC Fast Track assessment Mastery Test Question and Answer 2025/2026 Which of the following is a correct statement about in-network provider services? - ANS = HMO Plans generally cover only in-network services. In most cases, members pay the full cost of any out-of-network services received, with a few important exceptions. What costs count toward the out-of-pocket maximum for Medicare Advantage (MA) Plans? - ANS = The Out-of-Pocket Maximum includes costs the member pays for any Medicare-covered Part A or B services but does not include the cost of any plan premiums. Which of the following best describes eligibility to enroll in a stand-alone Prescription Drug Plan? - ANS = Entitled to Part A and/or enrolled in Part B and reside in the plan service area. Which of the following statements accurately describes a prescription drug stage? - ANS = INCORRECT: initial coverage stage Formulary is defined as: - ANS = A list of medications covered within the benefit plan, based on CMS guidelines, and developed in collaboration with providers and pharmacists. Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are all examples of what? - ANS = Utilization Management Rules Which of the following best describes the Late Enrollment Penalty (LEP)? - ANS = The amount added to the member's monthly plan premium if they did not enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for 63 or more continuous days. Next question What kind of financial assistance does a consumer receive who qualifies for Low Income Subsidy? - ANS = INCORRECT: A combination of subsidies and annual refund checks When does Medicare Supplement Open Enrollment take place? - ANS = INCORRECT: During the three months prior to the consumer's 65th birthday, the month of their birthday, and the three months following the month of their 65th birthday and enrolled in Medicare Part B. When is a Medicare Supplement Insurance consumer subject to underwriting and screened for eligibility? - ANS = When the consumer is not in their Medicare Supplement Open Enrollment or does not meet Guaranteed Issue criteria. Which of the following statements is true about election periods? - ANS = MA Open Enrollment Period can only be used by a consumer already enrolled in an MA Plan. Which statement regarding Star Ratings is true? - ANS = Medicare uses a 5-star rating system to illustrate a plan's performance and quality. Which of the following describes Permission to Contact (PTC) guidelines? - ANS = INCORRECT: The agent must obtain PTC no later than the start of a marketing appointment and can only discuss the products agreed upon by the consumer. What information should be obtained from the consumer when conducting a thorough needs assessment? (Select 2) - ANS = The providers they see and medications they take to determine network and formulary status. AND Their current health care coverage, including what they like about it and what they don't. Next question What is the purpose of the Statement of Understanding? - ANS = It ensures that when consumers complete the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling, and standard disclosures. Which of the following must an agent obtain no less than 48 hours (unless an exception applies) from the consumer prior to the start of an in-person, online, or telephonic marketing appointment? - ANS = Scope of Appointment To complete an Enrollment Application on behalf of a consumer, what authority must the individual have? - ANS = The individual must be legally authorized under applicable law