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UHC Medicare Certification exam || with questions and answers
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UHC Medicare Certification exam || with questions and answers
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UHC Medicare Certification exam || withquestions and answers
In order to qualify for Medicare, an individual must be 65 years old,
lawfully present in the United States, and meet one more CMS
enrollment criteria. What is that? - CORRECT ANSWER ; Be eligible
to recieve Social Security
A plan is not required to disenroll a member under CMS guidelines if the
member..... - CORRECT ANSWER ; Fails to pay plan premium. In
fact an MAO is never required to terminate a member on their own.
Mrs. Smith submits an enrollment request on November 11 and has no
special election period. What regular election period may she use and
what will her coverage effective date be? - CORRECT ANSWER ;
Annual Election Period, Jan 1
Are there open enrollment risks when a beneficiary has a Employer
Group Plan? - CORRECT ANSWER ; Yes, members should check
with their benefits administrator at work to avoid possibly losing
coverage. Beneficiaries may still be able to use employer coverage with
the plan that they join
What is the first step in finding appropriate Medicare coverage? -
CORRECT ANSWER ; The first step is to determine if the individual
is elegible to be covered under employer group coverage.
,What is the second step in finding appropriate Medicare coverage? -
CORRECT ANSWER ; Decide whether to select original Medicare A
& B or Medicare part C
If an individual chooses Medicare Part C, what is the next important
choice? - CORRECT ANSWER ; To decide if they want medical
benefits only or Part C with drug coverage.
If an individual wants Parts A and B original Medicare, what are the next
two choices to be made? - CORRECT ANSWER ; Decide if they want
Part D perscription Drug coverage, and decide if they want supplemental
coverage.
Can a Part D PDP be added to Original Medicare without cancelling
Original Medicare? - CORRECT ANSWER ; Yes, these work together
Can a Part D PDP be added to another Part D PDP without cancelling
the original Part D PDP? - CORRECT ANSWER ; No, only one plan
is allowed
Can a Part D PDP be added to a Med Sup plan without cancelling the
Med Sup plan? - CORRECT ANSWER ; Yes, a stand alone works with
Medigap
Can a Part D PDP be added to a Medical only part C plan without
cancelling the Medical only part C plan? - CORRECT ANSWER ; Not
,unless the Medical only part C plan is a PFFS plan, an MSA plan or a
1876 cost plan
Can a Part D PDP be added to a part C plan with prescription drug
coverage without cancelling the part C plan with prescription drug
coverage? - CORRECT ANSWER ; No, this enrollment will result in
the beneficiary being on original Medicare with a stand-alone PDP
Can a Part D PDP be added to a part C PFFS plan without cancelling the
part C PFFS plan? - CORRECT ANSWER ; Yes, PFFS works with
Stand-alone
Can a Part D PDP be added to a part C PFFS MA-PD plan without
cancelling the part C PFFS MA-PD plan? - CORRECT ANSWER ;
No, since the plan already has drug coverage, this would duplicate the
coverage
Can a Part D PDP be added to a part C MSA plan without cancelling the
part C MSA plan? - CORRECT ANSWER ; Yes, an MSA plan will
work with a stand alone PDP.
Can a Part D PDP be added to a 1876 cost plan without cancelling the
1876 cost plan? - CORRECT ANSWER ; Yes, because these plans are
not Advantage plans
What are the three main questions that you must clarify completely
about a clients situation before you can make an appropriate
, reccomendation for them? - CORRECT ANSWER ; What is their
financial situation, What is their current coverage, What are their
coverage needs?
What are the three requirements a client must meet in order to enroll in a
MA-only or an MA-PD plan? - CORRECT ANSWER ; Must have
Medicare A and B, Must be a permanent resident in the plans coverage
area, Must not have end stage renal disease
If a client has end stage renal disease, is there any way that they can they
still have a part C plan? - CORRECT ANSWER ; Yes, if the client has
had a kidney transplant which has ended the need for regular dialysis,
Yes, if they had a plan with a Medicare Provider Organization that lost
or failed to renew their contract with CMS, Yes. if they "age in" to
Medicare while a member of a plan with the same Medicare Provider
Organization
What is "Medicare Advantage Lock-In?" - CORRECT ANSWER ;
After the effective date of enrollment, the member will remain in the
plan and will not be permitted to disenroll or change plans. The member
is "locked in" until an applicable election period arises, either the annual
election period or a special election period.
As regards Medicare Advantage, the term Election means what? -
CORRECT ANSWER ; Either enrollment in, or disenrollment from, a
Medicare Advantage plan
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