UHC Medicare Basics Test 2023/2024 With 100% Correct Answers

UHC Medicare Basics Test A consumer currently has original Medicare and is enrolled in a stand alone prescription drug plan what will happen if the consumer enrolls in an MA plan that has integrated prescription drug coverage - ANSWER-the consumer will be automatically disenrolled from the standalone PDP upon in Roman in the MA plan that has integrated prescription drug coverage aside from a standalone Medicare prescription drug plan how else could a Medicare eligible consumer get Part D prescription drug coverage - ANSWER-they can enroll in a Medicare Advantage plan or other Medicare health plan that includes prescription drug coverage which of the following statements is not true about the coverage gap - ANSWER-all members reach the coverage gap which of these statements is true about the drug utilization management UN rules - ANSWER-prior authorization quantity limit and step therapy are some examples of the coverage rules how does a consumer who qualifies for low income subsidy receive financial assistance through their part of Medicare Part D costs - ANSWER-through subsidies such as lower or no monthly plan premiums an lower or no copayments which of the following list drug tiers from least expensive cost share to most expensive cost share - ANSWER-preferred generics generics preferred brand nonpreferred drug specialty which of the following is true about Medicare supplement insurance plans - ANSWER- plan benefit amounts automatically update when Medicare changes cost sharing amounts such as deductibles coinsurance and copayments which definition best describes Medicare Part A - ANSWER-the part of Medicare that helps with the cost of inpatient hospital stays it also helps with Hospice care and some skilled care for homebound which statement is true about members of a Medicare Advantage plan who wants to enroll in a Medicare supplement insurance plan - ANSWER-the consumer must be in a valid MA election or disenrollment. Who is eligible for Medicare - ANSWER-consumers age 65 or older consumers under 65 years of age with certain disabilities and consumers of all ages with ESRD or a LS which of the following defines a Medicare Advantage plan select two - ANSWER-MA plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage MA plans must provide benefits equivalent to original Medicare and most plans also offer additional benefits to be eligible for this plan type consumers must meet the following requirements entitled to Medicare Part A and enrolled in Part B reside in the planned service area which plan is described - ANSWER-Medicare Advantage Which type of MA plan is an HMO plan that also covers some benefits out of network generally at a higher cost - ANSWER-point of service POS plan when is Marys Medicare supplement open enrollment period if she turns 65 on September 23rd 2019 and her Medicare Part B effective date is September 1st 2019 - ANSWER-September 2019 through February 2020 a consumer with original Medicare might be interested in an MA plan because - ANSWER-MA plans typically provide additional coverage beyond original Medicare and often have established copayments for some benefits which of the following statements is true about a Medicare supplement insurance plan member who wants to enroll in an MA plan - ANSWER-Medicare supplement insurance cannot be used in conjunction with an MA plan therefore after receiving confirmation of enrollment into the MA plan the member should submit to their Medicare supplement insurance carrier a written request to cancel his/her policy which of the following statements does not correctly define prescription drug stages - ANSWER-a deductible and the amount the member must pay for every prescription medication regardless of what stage they are in a consumer may have to pay a late enrollment penalty if they did not enroll in a Medicare Advantage plan with the Part D benefits or stand alone prescription drug plan when they were first eligible for Medicare parts A and or Part B or win without credible prescription drug coverage for - ANSWER-63 continuous days or more being 65 or older being under 65 years of age with certain disabilities for more than 20 four months and being any age with E SRD or LS or each eligibility requirements for which program - ANSWER-original Medicare which of the following defines a medical advantage MA plan select two - ANSWER-MA plans or health plan options approved by Medicare and offered by the Centers for Medicare and Medicaid Services CMS MA plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage member Doug enrolled in a health maintenance organization HMO MA plan he saw an out of network doctor and received a bill for the entire cost of the visit Doug called Medicare to complain and stated that he was never told about these types of costs what should the agent and explain better to Doug when he was enrolled in the plan select three - ANSWER-that dog must receive coverage services from contract in network providers that in most cases Doug will pay the entire cost of the service if he sees an out of network provider that exceptions to the provider network requirement are emergency visits urgent care and rental dialysis services which can be obtained from out of network providers a consumer with original Medicare might be interested in an MA plan because - ANSWER-MA plans typically provide additional coverage beyond original Medicare and often have established copayments for some benefits 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 - ANSWER-Medicare Part D aside from a Medicare Advantage plan or other health plan that includes prescription drug coverage how else could a medicare eligible consumer get Part D prescription drug coverage - ANSWER-they can enroll on a standalone Medicare prescription drug plan PDP In what order do the four prescription drug coverage stages occur - ANSWER- deductible initial coverage coverage gap catastrophic coverage which of the following options or drug utilization management UM rules select three - ANSWER-quantity limit prior authorization step therapy formulary is defined as - ANSWER-Alyssa medications covered within the benefit plan based on CMS guidelines and develop in collaboration with physicians and pharmacists the new MACRA legislation which went into effect January 1st 2020 applies to all carriers offering Medicare supplement plans - ANSWER-true Joseph has original Medicare And was a patient in hospital last week what part of Medicare helps cover the cost to the inpatient hospital stay - ANSWER-part A What must be explained to consumers enrolling in an HMO health maintenance organization MA plan select three - ANSWER-in most cases they will pay the entire cost of the service if they see an out of network provider they must see contract in network providers in order to receive coverage under the plan the exception to the provider network requirement is emergency visits urgent care and renal dialysis services which can be obtained from out of network providers which of the following are MA plans that focus on using network providers to maximize the benefits and reduce out of network expenses - ANSWER-HMO POS PPO 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 - ANSWER-Medicare Part D which of the following best describes the late enrollment penalty LEP - ANSWER-the amount added to the members monthly plan premium if they did not enroll in a Medicare Advantage plan with Part D benefits or standalone prescription drug plan when they were first eligible for Medicare parts A and or B or went without creditable prescription drug coverage for 60 three continuous days or more