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Uhc Medicare Exam 2024/2025: Accurate Solutions
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Uhc Medicare Exam 2024/2025: Accurate Solutions
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UHC MEDICARE EXAM 2024/2025:ACCURATE SOLUTIONS
Joseph has Original Medicare and was a patient in the hospital last week.
What part of Medicare helps cover the costs of his inpatient hospital
stay? - Precise Answer ✔✔Part A
- Precise Answer ✔✔The consumer must be in a valid MA election or
disenrollment period.
Which of the following consumers would be eligible for Medicare? -
Precise Answer ✔✔Consumers age 65 or older, consumers under 65
years of age with certain disabilities for more than 24 months and
consumers of all ages with ESRD or ALS
Which of the following defines a Medicare Advantage (MA) Plan? -
Precise Answer ✔✔MA Plans are health plan options approved by
Medicare and offered by private insurance companies.
Janice wants to enroll in a 2021 Medicare Advantage plan. What
eligibility requirements must she meet? (Select the two answers that
apply.) - Precise Answer ✔✔Not have End Stage Renal Disease
(permanent kidney failure)Reside in the plan's service area
,What must be explained to consumers enrolling in an HMO (Health
Maintenance Organization) MA Plan? (Select 3) - Precise Answer ✔✔
Which of the following are MA Plans that focus on using network
providers to maximize the benefits and reduce out-of-network expenses?
- Precise Answer ✔✔HMO, POS, PPO
Which is true about Medicare Supplement Open Enrollment? - Precise
Answer ✔✔By federal law, Medicare Supplement Open Enrollment is
the first 6 months a consumer is 65 or older and enrolled in Medicare
Part B.
How does the Medicare Advantage Out-of-Pocket (OOP) maximum
work? - Precise Answer ✔✔The OOP maximum is a feature that limits
the amount of money a consumer will have to spend on Medicare-
covered health care services each year.
A consumer currently has Original Medicare and is enrolled in a stand-
alone Prescription Drug Plan (PDP). What will happen if the consumer
enrolls in an MA Plan that has integrated prescription drug coverage? -
Precise Answer ✔✔The consumer will be automatically disenrolled
from their stand-alone PDP upon enrollment in the MA Plan that has
integrated prescription drug coverage
A government program, offered only through a private insurance
company or other private company approved by Medicare, that provides
prescription drug coverage describes which of the following: - Precise
Answer ✔✔Medicare Parts A and B
,Which of the following statements is true about eligibility requirements
for Medicare Prescription Drug Plans? - Precise Answer ✔✔A
consumer must be entitled to Medicare Part A and/or enrolled in
Medicare Part B
What are two options for Medicare consumers to get Part D prescription
drug coverage (assuming they meet all eligibility requirements)? (Select
2) - Precise Answer ✔✔
Which of the following statements is not true about the Coverage Gap? -
Precise Answer ✔✔All members reach the Coverage Gap
Which of the following options are drug utilization management (UM)
rules? (Select 3) - Precise Answer ✔✔
Which of the following best describes the Late Enrollment Penalty
(LEP)? - Precise Answer ✔✔The amount 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 continuous days or more.
Through which means is financial assistance offered to a consumer who
qualifies for Low Income Subsidy for their part of Medicare Part D
costs? - Precise Answer ✔✔Through subsidies such as lower or no
monthly plan premiums and lower or no copayments
, Medications that are covered in a Plan's formulary have various levels of
associated member cost-sharing (copayments or coinsurance). What are
these drug levels called? - Precise Answer ✔✔Drug tiers
In states where Medicare Supplement Insurance underwriting criteria
can apply, all of the following underwriting criteria apply EXCEPT: -
Precise Answer ✔✔Consumers may be underwritten to determine their
acceptance and, if applicable, their rate.
The new MACRA legislation, which went into effect January 1, 2020,
applies to all carriers offering Medicare supplement plans. - Precise
Answer ✔✔TRUE
Which of the following is NOT true of Medicare Supplement Insurance
Plans? - Precise Answer ✔✔Plan benefit amounts automatically update
when Medicare changes cost sharing amounts, such as deductibles,
coinsurance and copayments. NOT
Which definition best describes Medicare Part A?
The part of Medicare that is a voluntary program offered by private
insurance companies that provides prescription drug coverage for an
additional monthly premium.
The part of Medicare that offers combined medical and prescription drug
coverage.
The part of Medicare that helps with the cost of inpatient hospital stays.
It also helps with hospice care and some skilled care for the homebound.
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