UHC CERTIFICATIONS EXAM 2024/100 QUESTIONS AND CORRECT VERIFIE ANSWERS/ LATEST UPDATE 2024/ALREADY RATED A+
Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? - ACC SOLUTION:-Her enrollment in Medicare Parts A a...
UHC CERTIFICATIONS EXAM 2024/100 QUESTIONS AND CORRECT VERIFIE ANSWERS/ LATEST UPDATE 2024/ALREADY RATED A+ Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? - ACC SOLUTION :-Her enrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements. Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to enroll in a Medicare Supplement Insurance Plan? - ACC SOLUTION :-
When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA Plan. Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months, and being any age with ESRD or ALS are each eligibility requirements for which program? - ACC SOLUTION :-Original Medicare Which of the following defines a Medicare Advantage (MA) Plan? (Select 2) - ACC SOLUTION: -1. MA Plans must provide benefits equivalent to Original Medicare, and most plans also offer additional benefits . 2. MA Plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage. Which of the following is NOT an eligibility requirement for enrollment in a Medicare Advantage Plan? - ACC SOLUTION :-Does not have any pre - existing conditions such as diabetes or End Stage Renal Disease (ESRD) Which of the following statements is correct about HMO MA Plans? - ACC SOLUTION: -Members must receive covered services from contracted network providers with limited exceptions. Which of the following is NOT a correct statement about in-network provider services? - ACC SOLUTION :-(INCORRECT) Network -based MA plans have a provider network the member can use, and some plans also cover certain services outside the network. What is true about Medicare supplement open enrollment? ACC SOLUTION: - ✅(INCORRECT) A consumer who waits to enroll in Medicare Part B until age 66 or older cannot qualify for Medicare Supplement Open Enrollment. (INCORRECT) It is the only time a consumer is eligible to purchase a Medicare Supplement Insurance Plan. Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what counts toward the Out -of-Pocket Maximum. Which of the following is accurate? - ACC SOLUTION :-The Out -of-Pocket Maximum will include her costs toward any Medicare -covered Part A or B services . Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enroll in an MA Plan? ACC SOLUTION: - ✅Medicare Supplement Insurance cannot be used in conjunction with an MA Plan; therefore, after receiving confirmation of enrollment into the MA Plan, the member must cancel their Medicare Supplement Insurance policy according to their carrier's rules. Which of the following best defines Medicare Part D? - ACC SOLUTION :-It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides prescription drug coverage. Which of the following is a fact about Medicare Prescription Drug Plans? - ACC SOLUTION: -To enroll, member must be in plans service area What are two options for Medicare clients to get Part D prescription drug coverage (assuming they meet all eligibility requirements)? (Select 2) - ACC SOLUTION: -
Enroll in a stand -alone Medicare Prescription Drug Plan (PDP) Enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverage. Which of the following statements does NOT correctly define prescription drug stages? - ACC SOLUTION :-A deductible is the amount the member must pay for every prescription medication, regardless of what stage they are in. Which of these statements is NOT true about the drug utilization management (UM) rules? - ACC SOLUTION :-(INCORRECT) Prior authorization, quantity limit, and step therapy are some examples of UM rules What is 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? - ACC SOLUTION :-Late Enrollment Penalty (LEP)
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