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UHC MEDICARE BASICS ASSESSMENT QUESTIONS AND ANSWER1.
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UHC MEDICARE BASICS ASSESSMENT QUESTIONS AND ANSWER1.
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UHC MEDICARE BASICS ASSESSMENTQUESTIONS AND ANSWERS
In rwhich rtwo rparts rof rMedicare ris renrollment rgenerally rautomatic rfor religible rconsumers
rwho rare rreceiving rSocial rSecurity rbenefits, rUNLESS rthey rchoose rto rdelay rtheir
rcoverage? r- rCorrect rAnswer r- rParts rA rand rB
Which rstatement ris rtrue rabout rmembers rof ra rMedicare rAdvantage r(MA) rPlan rwho rwant
rto renroll rin ra rMedicare rSupplement rInsurance rPlan? r- rCorrect rAnswer r- rThe rconsumer
rmust rbe rin ra rvalid rMA relection ror rdisenrollment rperiod.
Provided rother religibility rrequirements rare rmet, rwho ris religible rfor rMedicare? r- rCorrect
rAnswer r- rConsumers rage r65 ror rolder, rconsumers runder r65 ryears rof rage rwith ra rqualifying
rdisability rand rconsumers rof rall rages rwith rESRD ror rALS rwho rare rreceiving rSocial
rSecurity rDisability rInsurance r(SSDI) rfor rALS.
Which rof rthe rfollowing rdefines ra rMedicare rAdvantage r(MA) rPlan? r(Select r3) r- rCorrect
rAnswer r- r-An rMA rPlan ris ra rhealth rplan roption rapproved rby rMedicare rand roffered rby
rprivate rinsurance rcompanies.
-An rMA rPlan ris rpart rof rMedicare rand ris ralso rcalled rPart rC.
-An rMA rPlan rprovides rMedicare rhospital rand rmedical rinsurance r(Medicare rPart rA rand
rPart rB) rand roften rincludes rMedicare rprescription rdrug rcoverage r(Part rD).
To rbe religible rfor rthis rplan rtype, rconsumers rmust rmeet rthe rfollowing rrequirements: rbe
rentitled rto rMedicare rPart rA rand renrolled rin rPart rB, rand rreside rin rthe rplan's rservice rarea.
rWhich rplan ris rbeing rdescribed? r- rCorrect rAnswer r- rMedicare rAdvantage
Which rof rthe rfollowing rstatements ris rcorrect rabout rHMO rMA rPlans? r- rCorrect rAnswer r-
rMembers rmust rreceive rcovered rservices rfrom rcontracted rnetwork rproviders rwith rlimited
rexceptions.
Which rof rthe rfollowing rare rMA rPlans rthat rfocus ron rusing rnetwork rproviders rto rmaximize
rthe rbenefits rand rreduce rout-of-network rexpenses? r- rCorrect rAnswer r- rHMO, rPOS, rPPO
When rdoes rMedicare rSupplement rOpen rEnrollment rtake rplace? r- rCorrect rAnswer r-
rDuring rthe rfirst rsix rmonths ra rconsumer ris r65 ror rolder rand renrolled rin rMedicare rPart rB.
What rcosts rcount rtoward rthe rout-of-pocket rmaximum rfor rMedicare rAdvantage r(MA)
rPlans? r- rCorrect rAnswer r- rThe rOut-of-Pocket rMaximum rincludes rcosts rthe rmember rpays
rfor rany rMedicare-covered rPart rA ror rB rservices rbut rdoes rnot rinclude rthe rcost rof rany rplan
rpremiums.
, A rconsumer rcurrently rhas rOriginal rMedicare rand ris renrolled rin ra rstand-alone rPrescription
rDrug rPlan r(PDP). rWhat rwill rhappen rif rthe rconsumer renrolls rin ran rMA rPlan rthat rhas
rintegrated rprescription rdrug rcoverage? r- rCorrect rAnswer r- rThe rconsumer rwill rbe
rautomatically rdisenrolled rfrom rtheir rstand-alone rPDP rupon renrollment rin rthe rMA rPlan
rthat rhas rintegrated rprescription rdrug rcoverage
What ris rMedicare rPart rD? r- rCorrect rAnswer r- rA rvoluntary rprogram, roffered rby rprivate
rinsurance rcompanies rthat rare rcontracted rwith rthe rfederal rgovernment, rthat rprovides
rprescription rdrug rcoverage rfor ran radditional rmonthly rplan rpremium.
Which rconsumer ris religible rfor ra rstand-alone rMedicare rPrescription rDrug rPlan? r- rCorrect
rAnswer r- rJoseph, rwho ris renrolled rin rMedicare rPart rA rand rMedicare rPart rB rand rresides rin
rthe rplan's rservice rarea.
A rconsumer rwith ronly rPart rA rresiding rin rthe rplan's rservice rarea rcan renroll rin rwhich rplan
rtype rto rget rPart rD rcoverage? r- rCorrect rAnswer r- rA rstand-alone rPart rD rPlan.
Which rof rthe rfollowing rstatements raccurately rdescribes ra rprescription rdrug rstage? r-
rCorrect rAnswer r- rStarting rin r2024, rthe rcatastrophic rcoverage rstage ris rwhen rthe rmember
rwill rpay rnothing rfor rcovered rdrugs rfor rthe rremainder rof rthe rplan ryear.
Step rTherapy, rPrior rAuthorization, rQuantity rLimit, r7-day rlimit, rDispensing rLimit rand
rLimited rAccess rare rall rexamples rof rwhat? r- rCorrect rAnswer r- rUtilization rManagement
rRules
A rconsumer rmay rhave rto rpay ra rLate rEnrollment rPenalty r(LEP) rif rthey rdid rNOT renroll rin ra
rMedicare rAdvantage rplan rwith rPart rD rbenefits ror rstand-alone rprescription rdrug rplan
rwhen rthey rwere rfirst religible rfor rMedicare rParts rA rand/or rB ror rwent rwithout rcreditable
rprescription rdrug rcoverage rfor r______________. r- rCorrect rAnswer r- r63 ror rmore
rcontinuous rdays
How rdoes ra rconsumer rwho rqualifies rfor rLow rIncome rSubsidy rreceive rfinancial
rassistance rfor rtheir rpart rof rMedicare rPart rD rcosts? r- rCorrect rAnswer r- rThrough rsubsidies
rsuch ras rlower ror rno rmonthly rplan rpremiums rand rlower ror rno rcopayments.
Which rof rthe rfollowing ris ra rcharacteristic rof ra rdrug rtier? r- rCorrect rAnswer r- rAll rof rthe
rdrugs rin rthe rtier rhave rthe rsame rcopayment ror rcoinsurance.
Which rof rthe rfollowing ris rtrue rabout rMedicare rSupplement rInsurance runderwriting rcriteria
rin rstates rwhere runderwriting rapplies? r- rCorrect rAnswer r- rUnderwriting ris rrequired rif rthe
rconsumer ris rnot rin rtheir rMedicare rSupplement rOpen rEnrollment rperiod ror rdoes rnot rmeet
rGuaranteed rIssue rcriteria.
Which rof rthe rfollowing rare rtrue rabout rthe rMedicare rAccess rand rCHIP rReauthorization
rAct rof r2015 r(MACRA) rPlans rand rthe rimpact rto rPlans rC rand rF? r(Select r2) r- rCorrect
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