UHC CERTIFICATION 2 LATEST VERSIONS ACTUAL
EXAM 200 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
Medicare .....ANSWER.....Federal health insurance program
Medicare is administered by whom? .....ANSWER.....CMS (
Centers for medicare and medicaid services)
Parts A & B of medicare are .....ANSWER.....federal health
insurance program referred to as original medicare
Part A? .....ANSWER.....Hospital insurance
Part B? .....ANSWER.....Medical insurance
What doesnt medicare cover? .....ANSWER.....routine dental, eye
care hearing exam,deductibles, coinsurance and copayments
Part C? .....ANSWER.....Medicare Advantage Plans
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MA covers? .....ANSWER.....Part A &B coverage, and some part D
coverage
MA plans are not? .....ANSWER.....Medicare supplement insurance
plans
What offers lower monthly premiums MADP or supplement?
.....ANSWER.....MADP
do MAP's have a annual maximum OOP maximum that limits the
amount of money a member must spend every year for covered
services? .....ANSWER.....YES
MA plans integrate what type of additonal coverage?
.....ANSWER.....part D prescription drug coverage
If a customer wants to keep their stand alone prescription drug
plan, what may the customer want to enroll in?
.....ANSWER.....MA-only PFFS plan
What is a stand alone drug plan called? .....ANSWER.....PDP
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WHat is PFFS? .....ANSWER.....Private Fee for Service (PFFS) -
Plans that allow you to go to any doctor or hospital that accepts
their terms
If a customer lives in a rural area, what type of plan may they
want because it gives them freedom to access doctors that may
not be in their network? .....ANSWER.....PFFS plan
Do HMO's require referals? .....ANSWER.....Yes
Do PPO's require a referal? .....ANSWER.....No
When a member enrolls in a MA plan, they receive their
coverage from medicare or the MA plan? .....ANSWER.....MA
plan
When a customer is enrolled in a MA plan, they must continue
paying their premiums for what other plan? .....ANSWER.....Part B
MA plans have a maxium annual limit on OOP costs called a?
.....ANSWER.....MOOP amount ( Maxium out of pocket)
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When a member is enrolled in a MA plan, they are automatically
disenrolled from any other MA plan or PDP( prescription drug
plan) in which they are enrolled as of the new plans_____?
.....ANSWER.....effective date
An exception exisits for MA-only PFFS plans as a member can
also be enrolled in a what? .....ANSWER.....Stand alone PDP
If a member enrolls in a MA plan, what must the member do?
.....ANSWER.....Cancel in writing their medicare supplement
insurance policy with the carrier after their request to enroll in
MA plan has been approved.
Medicare supplement insurance policies cannot be used in
conjunction with what type of plan? .....ANSWER.....MA plan
A medicare supplement insurance plan helps to cover some of the
OOP costs associated with? .....ANSWER.....original medicare.
A medicare supplement insurance plan does NOT pay the cost-
sharing of what type of plan? .....ANSWER.....MA plan