UHC MEDICARE BASICS TEST | QUESTIONS
AND CORRECT ANSWERS | GRADED A+ |
VERIFIED ANSWERS | JUST RELEASED
Through which means is financial assistance offered to a consumer who
qualifies for Low Income Subsidy for their part of Medicare Part D costs? ---
------CORRECT ANSWER-----------------Through subsidies such as lower or
no monthly plan premiums and lower or no copayments.
Formulary is defined as: ---------CORRECT ANSWER-----------------A list of
medications covered within the benefit plan, based on CMS guidelines and
developed in collaboration with physicians and pharmacists.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA),
which went into effect January 1, 2020, applies to all carriers offering
Medicare supplement plans. ---------CORRECT ANSWER-----------------True
What kind of financial assistance does a consumer receive who qualifies
for Low Income Subsidy ---------CORRECT ANSWER-----------------Lower or
no monthly plan premiums and lower or no copayments
What is the Late Enrollment Penalty (LEP) amount for not enrolling in a
Medicare Advantage plan with Part D benefits or a stand-alone prescription
drug plan? ---------CORRECT ANSWER-----------------The Late Enrollment
Penalty is 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.
,What is the purpose of Step Therapy in Medicare Advantage Plans? ---------
CORRECT ANSWER-----------------Step Therapy is a utilization
management rule that requires members to try a less expensive drug
before moving on to a more costly one, helping to control costs and ensure
appropriate medication use.
What is the Coverage Gap in Medicare Part D? ---------CORRECT
ANSWER-----------------The Coverage Gap, also known as the 'donut hole,'
is a temporary limit on what the drug plan will cover for prescription drugs,
where the member pays a higher cost for their medications until they reach
catastrophic coverage.
What is the significance of the Medicare Access and CHIP Reauthorization
Act of 2015 (MACRA) for Medicare Supplement Plans? ---------CORRECT
ANSWER-----------------Consumers eligible for Medicare Part A before
January 1, 2020, can enroll in Plan C or F even after 2020 and can keep
their plans as long as they choose, while those eligible for Medicare Part A
on or after January 1, 2020, will not be able to purchase Plans C or F.
What is the purpose of Prior Authorization in Medicare Advantage Plans? --
-------CORRECT ANSWER-----------------Prior Authorization is a utilization
management rule that requires approval from the plan before certain
medications or services are covered, ensuring they are medically
necessary and cost-effective.
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 ---------CORRECT
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 ---------
CORRECT ANSWER-----------------they can enroll in a Medicare Advantage
plan or other Medicare health plan that includes prescription drug coverage
Milton is retiring on his 65th birthday. He is eligible for Medicare and
already receives Social Security benefits. How does he enroll in Original
Medicare?
-He can only sign up for Medicare Parts A and/or B at his local Social
Security office.
-He can sign up for Medicare Parts A and/or B with any licensed insurance
agent.
-His enrollment in Medicare Parts A and B is generally automatic if he
meets all eligibility requirements
-He must enroll in Medicare Parts A and B through his current or former
employer. ---------CORRECT ANSWER-----------------His enrollment in
Medicare Parts A and B is generally automatic if he 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?
When a consumer enrolls in a Medicare Supplement Insurance Plan, they
are not automatically disenrolled from their MA Plan.
When a consumer enrolls in a Medicare Supplement Insurance Plan, they
are automatically disenrolled from their MA Plan.
A consumer can use a Medicare Supplement Insurance Plan and an MA
Plan at the same time.
A member does not need a valid election period to disenroll from an MA
plan. ---------CORRECT ANSWER-----------------When a consumer enrolls in
a Medicare Supplement Insurance Plan, they are not automatically
disenrolled from their MA Plan.
, Which of the following lists drug tiers from least expensive cost share to
most expensive cost share? ---------CORRECT ANSWER-----------------
Preferred Generics, Generics, Preferred Brand (and some higher-cost
generics), Non-Preferred Drug (and some higher-cost generics), Specialty
When is a Medicare Supplement Insurance consumer subject to
underwriting and screened for eligibility? ---------CORRECT ANSWER--------
---------When the consumer is not in his/her Medicare Supplement Open
Enrollment or does not meet Guaranteed Issue criteria.
Which of the following is NOT true about the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA) impact to Plans C and F? ---------
CORRECT ANSWER-----------------Consumers already enrolled in Plans C
or F are required to change plans.
Which of the following is NOT true of Medicare Supplement Insurance
Plans? ---------CORRECT ANSWER-----------------To see a specialist,
insured members must obtain referrals from a primary care physician.
In which two parts of Medicare is enrollment generally automatic for eligible
consumers who are receiving Social Security benefits, UNLESS they
choose to delay their coverage? ---------CORRECT ANSWER-----------------
Parts A and B
Which statement is true about members of a Medicare Advantage (MA)
Plan who want to enroll in a Medicare Supplement Insurance Plan? ---------
CORRECT ANSWER-----------------The consumer must be in a valid MA
election or disenrollment period.
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