UHC Final Exam With All Complete Solutions 2024.

Which of the following is a correct statement about in-network provider services? - Answer HMO Plans cover only in-network services. In most cases, members pay the full cost of any out-of-network services received, with a few important exceptions. Which of the following are eligibility requirements for enrollment in a Medicare Advantage (MA) Plan? (Select 3) - Answer Resides in the plan's service area Is enrolled in Medicare Part B Is entitled to Medicare Part A Which statement is true about the Medicare Advantage (MA) Out-of-Pocket Maximum? - Answer All MA plans have an Out-of-Pocket Maximum to help limit the member's out-of-pocket costs for Medicare-covered medical services. Which of the following best describes eligibility to enroll in a stand-alone Prescription Drug Plan? - Answer Entitled to Part A and/or enrolled in Part B and reside in the plan service area. Which of the following statements is NOT true about the Coverage Gap? - Answer All members reach the Coverage Gap Which of the following is a characteristics of a drug tier? - Answer All of the drugs in the tier have the same copayment or coinsurance. Which of these statements is true about the drug utilization management (UM) rules? - Answer Prior authorization, quantity limit, and step therapy are some examples of the UM rules. A consumer may have to pay a Late Enrollment Penalty (LEP) 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