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UHC CERTIFICATION LATEST VERSION ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+€20,73
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UHC CERTIFICATION LATEST VERSION ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
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UHC CERTIFICATION
UHC CERTIFICATION LATEST VERSION
ACTUAL EXAM 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
UHC CERTIFICATION LATEST VERSION
ACTUAL EXAM 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
UHC CERTIFICATION LATEST VERSION 2023-2024
ACTUAL EXAM 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
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 meets 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 is 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 age 66 or older cannot qualify for 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 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 Supplement 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 following 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 utilization 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 who 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
Formulary is defined as: - ANSWER-A list of medications covered within the benefit plan, based on CMS
guidelines and developed in collaboration with physicians and pharmacists.
Which of the following is true about Medicare Supplement Insurance underwriting criteria in states
where underwriting applies? - ANSWER-Underwriting is required if the consumer is not in their
Medicare Supplement Open Enrollment period or does not meet Guaranteed Issue criteria.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which went into effect January 1,
2020, applies to all carriers offering Medicare supplement plans. - ANSWER-True
Which of the following is NOT true of Medicare Supplement Insurance Plans? - ANSWER-(INCORRECT)
Plan benefit amounts automatically update when Medicare changes cost sharing amounts, such as
deductibles, coinsurance and copayments.
Which of the following consumers are eligible for Medicare if other eligibility requirements are met? -
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? (Select 3) - ANSWER-An MA Plan is a
health plan option approved by Medicare and offered by private insurance companies.
An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often
includes Medicare prescription drug coverage (Part D).
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