UHC CERTIFICATION 2 LATEST VERSIONS 2024-
2025 ACTUAL EXAM 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |
Terms in this set (94)
Lisa turned 65 and is now Her enrollment in Medicare Parts A and B is generally
eligible for Medicare. She automatic if she meets all eligibility requirements.
already receives Social
Security benefits. How does
she enroll in Original
Medicare?
Which statement is true When a consumer enrolls in a Medicare Supplement
about a member of a Insurance Plan, they are not automatically disenrolled
Medicare Advantage (MA) from their MA Plan.
Plan who wants to enroll in
a Medicare Supplement
Insurance Plan?
Being 65 or older, being Original Medicare
under 65 years of age with
certain disabilities for more
than 24 months, and being
any age with ESRD or ALS
are each eligibility
requirements for which
program?
, 1. MA Plans must provide benefits equivalent to Original
Which of the following Medicare, and most plans also offer additional benefits.
defines a Medicare
Advantage (MA) Plan? 2. MA Plans provide Medicare hospital and medical
(Select 2) insurance and often include Medicare prescription drug
coverage.
Which of the following is Does not have any pre-existing conditions such as
NOT an eligibility diabetes or End Stage Renal Disease (ESRD)
requirement for enrollment
in a Medicare Advantage
Plan?
Which of the following Members must receive covered services from
statements is correct about contracted network providers with limited exceptions.
HMO MA Plans?
Which of the following is (INCORRECT) Network-based MA plans have a provider
NOT a correct statement network the member can use, and some plans also cover
about in-network provider certain services outside the network.
services?
(INCORRECT) A consumer who waits to enroll in
Medicare Part B until age 66 or older cannot qualify for
What is true about
Medicare Supplement Open Enrollment.
Medicare supplement open
enrollment?
(INCORRECT) It is the only time a consumer is eligible to
purchase a Medicare Supplement Insurance Plan.
Jennifer is enrolling into a The Out-of-Pocket Maximum will include her costs
Medicare Advantage (MA) toward any Medicare-covered Part A or B services.
plan and wants to know
what counts toward the
Out-of-Pocket Maximum.
Which of the following is
accurate?
, Which of the following Medicare Supplement Insurance cannot be used in
statements is true about a conjunction with an MA Plan; therefore, after receiving
Medicare Supplement confirmation of enrollment into the MA Plan, the
Insurance Plan member member must cancel their Medicare Supplement
who wants to enroll in an Insurance policy according to their carrier's rules.
MA Plan?
It is a government program, offered only through a
Which of the following best private insurance company or other private company
defines Medicare Part D? approved by Medicare, which provides prescription
drug coverage.
Which of the following is a To enroll, member must be in plans service area
fact about Medicare
Prescription Drug Plans?
What are two options for Enroll in a stand-alone Medicare Prescription Drug Plan
Medicare consumers to get (PDP)
Part D prescription drug
coverage (assuming they Enroll in a Medicare Advantage Plan or other Medicare
meet all eligibility health plan that includes prescription drug coverage
requirements)? (Select 2)
Which of the following A deductible is the amount the member must pay for
statements does NOT every prescription medication, regardless of what stage
correctly define they are in.
prescription drug stages?
Which of these statements (INCORRECT) Prior authorization, quantity limit, and step
is NOT true about the drug therapy are some examples of UM rules
utilization management
(UM) rules?
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