UHC Certifications Complete Questions And
Answers
Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits.
How does she enroll in Original Medicare? - answerHer enrollment in Medicare Parts A and
B is generally automatic if she meets all eligibility requir...
EXAM STUDY MATERIALS July 29, 2024 12:59 PM UHC C ertificat ions Complete Questions And Answers Lisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? - answer✔✔Her enrollment in Medicare Parts A and B is generally automatic if she me ets 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? - answer✔✔When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA Plan. Being 65 or older, being 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? - answer✔✔Original Medicare Which of the following defines a Medicare Advantage (MA) Plan? (Select 2) - answer✔✔1. MA Plans must provide benefits equivalent to Original Medicare, and most plans also offer additional benefits. 2. MA Plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage. Which of the following is NOT an eligibility requirement for enrollment in a Medicare Advantage Plan? - answer✔✔Does not have any pre -existing conditions such as diabetes or End Stage Renal Disease (ESRD) Which of the following statements i s correct about HMO MA Plans? - answer✔✔Members must receive covered services from contracted network providers with limited exceptions. Which of the following is NOT a correct statement about in -network provider services? - answer✔✔(INCORRECT) Network -based MA plans have a provider network the member can use, and some plans also cover certain services outside the network. What is true about Medicare supplement open enrollment? - answer✔✔(INCORRECT) A consumer who waits to enroll in Medicare Part B until ag e 66 or older cannot qualify for Medicare Supplement Open Enrollment. EXAM STUDY MATERIALS July 29, 2024 12:59 PM (INCORRECT) It is the only time a consumer is eligible to purchase a Medicare Supplement Insurance Plan. Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what counts toward the Out -of-Pocket Maximum. Which of the following is accurate? - answer✔✔The Out -
of-Pocket Maximum will include her costs toward any Medicare -covered Part A or B services. Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enroll in an MA Plan? - answer✔✔Medicare Supplement Insurance cannot be used in conjunction with an MA Plan; therefore, after receiving confirmation of enrollment into the MA Plan, the member must cancel their Medicare S upplement Insurance policy according to their carrier's rules. Which of the following best defines Medicare Part D? - answer✔✔It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides prescription drug coverage. Which of the following is a fact about Medicare Prescription Drug Plans? - answer✔✔To enroll, member must be in plans service area What are two options for Medicare consumers to get Part D prescription drug coverage (assuming they meet all eligibility requirements)? (Select 2) - answer✔✔Enroll in a stand -alone Medicare Prescription Drug Plan (PDP) Enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverage Which of the foll owing statements does NOT correctly define prescription drug stages? - answer✔✔A deductible is the amount the member must pay for every prescription medication, regardless of what stage they are in. Which of these statements is NOT true about the drug util ization management (UM) rules? - answer✔✔(INCORRECT) Prior authorization, quantity limit, and step therapy are some examples of UM rules What is 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 or more continuous days? - answer✔✔Late Enrollment Penalty (LEP) Can a consumer w ho qualifies for Low Income Subsidy receive financial assistance for their part of Medicare Part D costs? - answer✔✔Yes, through subsidies such as lower or no monthly plan premiums and lower or no copayments
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