UHC CERTIFICATION BASICS REAL EXAM LATEST
VERSION 2024-2025 ACTUAL QUESTIONS AND
ANSWERS GRADED A+.
medicare supplement insurance plan does NOT pay the cost-sharing of
what type of plan? - ANSWER-MA plan
when a client enrolls in a MA plan, will it automatically terminate their
MA plan? - ANSWER-NO
Can a customer call to terminate their Med Sup plan? - ANSWER-no it
must be done in writing
What are the different types of MA plans? - ANSWER-HMO, POS, PPO,
RPPO, PFFS, SNP, and MSA
For an HMO, they customer must us IN network providers, what are the
exceptions to their rule? - ANSWER-Emergencies, Urgent care, and renal
dialysis services.
In a HMO plan, does a member have to choose a PCP? and do they
require referrals to see a specialist? - ANSWER-Yes
,In a POS plan, does a member need a referral from their PCP to see a
specialist? - ANSWER-yes
Can a member with a POS plan see a specialist? - ANSWER-Yes, but they
may have to pay a higher cost, and there coverage limits
With a PFFS plan, can a member seek treatment from any medicare
eligible provider who agrees to accept the plans conditions and
payment rates? - ANSWER-Yes
Does a PCP need to be selected with a PFFS plan? - ANSWER-No
What is the only plan to offer non-network PFFS plans? - ANSWER-UHC
What are SNP's for? ( Dual SNP) - ANSWER-People who have both
medicare and Medicaid
Institutional SNP? - ANSWER-Nursing homes
Chronic condition SNP? - ANSWER-people who have certain chronic
medical conditions
MSA? - ANSWER-Medical savings account
, What does a MSA do? - ANSWER-Combines a high deductible medicare
advantage plan and a bank account
How does MSA plans work? - ANSWER-the plan deposits money from
emdicare in the account which can then be used to pay for medical
expenses until their deductible is met
Does UHC currently offer a MSA? - ANSWER-no
MA plans include some key features such as? - ANSWER-Prescription
drug coverage, PCPs and a OOP maxium
In a MA-Part D plan, A member will be disenrolled from their stand
alone PDP upon enrollment in a ? - ANSWER-MA-PD
in a MA-part D plan, A member will be disenrolled from their MA-PD
upon enrollment in? - ANSWER-a stand-alone PDP
With MA only, a member will be disenrolled from their stand alone PDP
upon enrolling in a? - ANSWER-Non-PFFS MA-only plan
in MA-only, a member will be disenrolled from their non-PFFS MA-only
plan upon enrolling in a? - ANSWER-Stand alone PDP
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