Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

UHC Medicare Basics Assessment Exam (2024/2025) | Actual Questions and Answers Latest Upda, Exams of Personal Health

In which two parts of Medicare is enrollment generally automatic for eligible consumers who are receiving Social Security benefits, UNLESS they choose to delay their coverage? - ✔✔Parts A and B Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan? - ✔✔The consumer must be in a valid MA election or disenrollment period.

Typology: Exams

2023/2024

Available from 08/29/2024

Holygrams
Holygrams 🇺🇸

3.7

(3)

2.2K documents

1 / 5

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
UHC Medicare Basics Assessment Exam (2024/2025) | Actual Questions and
Answers Latest Updated 2024/2025 (Graded A+)
In which two parts of Medicare is enrollment generally automatic for eligible consumers who are
receiving Social Security benefits, UNLESS they choose to delay their coverage? - ✔✔Parts A and B
Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a
Medicare Supplement Insurance Plan? - ✔✔The consumer must be in a valid MA election or
disenrollment period.
Provided other eligibility requirements are met, who is eligible for Medicare? - ✔✔Consumers age 65 or
older, consumers under 65 years of age with a qualifying disability and consumers of all ages with ESRD
or ALS who are receiving Social Security Disability Insurance (SSDI) for ALS.
Which of the following defines a Medicare Advantage (MA) Plan? (Select 3) - ✔✔-An MA Plan is a health
plan option approved by Medicare and offered by private insurance companies.
-An MA Plan is part of Medicare and is also called Part C.
-An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often
includes Medicare prescription drug coverage (Part D).
To be eligible for this plan type, consumers must meet the following requirements: be entitled to
Medicare Part A and enrolled in Part B, and reside in the plan's service area. Which plan is being
described? - ✔✔Medicare Advantage
Which of the following statements is correct about HMO MA Plans? - ✔✔Members must receive
covered services from contracted network providers with limited exceptions.
Which of the following are MA Plans that focus on using network providers to maximize the benefits and
reduce out-of-network expenses? - ✔✔HMO, POS, PPO
When does Medicare Supplement Open Enrollment take place? - ✔✔During the first six months a
consumer is 65 or older and enrolled in Medicare Part B.
pf3
pf4
pf5

Partial preview of the text

Download UHC Medicare Basics Assessment Exam (2024/2025) | Actual Questions and Answers Latest Upda and more Exams Personal Health in PDF only on Docsity!

UHC Medicare Basics Assessment Exam ( 2024 /2025) | Actual Questions and

Answers Latest Updated 2024/2025 (Graded A+)

In which two parts of Medicare is enrollment generally automatic for eligible consumers who are receiving Social Security benefits, UNLESS they choose to delay their coverage? - ✔✔Parts A and B Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan? - ✔✔The consumer must be in a valid MA election or disenrollment period. Provided other eligibility requirements are met, who is eligible for Medicare? - ✔✔Consumers age 65 or older, consumers under 65 years of age with a qualifying disability and consumers of all ages with ESRD or ALS who are receiving Social Security Disability Insurance (SSDI) for ALS. Which of the following defines a Medicare Advantage (MA) Plan? (Select 3) - ✔✔-An MA Plan is a health plan option approved by Medicare and offered by private insurance companies.

  • An MA Plan is part of Medicare and is also called Part C.
  • An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often includes Medicare prescription drug coverage (Part D). To be eligible for this plan type, consumers must meet the following requirements: be entitled to Medicare Part A and enrolled in Part B, and reside in the plan's service area. Which plan is being described? - ✔✔Medicare Advantage Which of the following statements is correct about HMO MA Plans? - ✔✔Members must receive covered services from contracted network providers with limited exceptions. Which of the following are MA Plans that focus on using network providers to maximize the benefits and reduce out-of-network expenses? - ✔✔HMO, POS, PPO When does Medicare Supplement Open Enrollment take place? - ✔✔During the first six months a consumer is 65 or older and enrolled in Medicare Part B.

What costs count toward the out-of-pocket maximum for Medicare Advantage (MA) Plans? - ✔✔The Out-of-Pocket Maximum includes costs the member pays for any Medicare-covered Part A or B services but does not include the cost of any plan premiums. 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? - ✔✔The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in the MA Plan that has integrated prescription drug coverage What is Medicare Part D? - ✔✔A voluntary program, offered by private insurance companies that are contracted with the federal government, that provides prescription drug coverage for an additional monthly plan premium. Which consumer is eligible for a stand-alone Medicare Prescription Drug Plan? - ✔✔Joseph, who is enrolled in Medicare Part A and Medicare Part B and resides in the plan's service area. A consumer with only Part A residing in the plan's service area can enroll in which plan type to get Part D coverage? - ✔✔A stand-alone Part D Plan. Which of the following statements accurately describes a prescription drug stage? - ✔✔Starting in 2024, the catastrophic coverage stage is when the member will pay nothing for covered drugs for the remainder of the plan year. Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are all examples of what? - ✔✔Utilization Management Rules A consumer may have to pay a Late Enrollment Penalty (LEP) 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

When is a Medicare Supplement Insurance consumer subject to underwriting and screened for eligibility? - ✔✔When the consumer is not in their Medicare Supplement Open Enrollment or does not meet Guaranteed Issue criteria. Which of the following statements is true about using a 5-Star Special Enrollment Period (SEP)? - ✔✔It can be used once from December 8 through November 30 to enroll in a 5-Star plan and coverage will start the first of the month following receipt of the enrollment application. Milton is retiring on his 65th birthday. He is eligible for Medicare and already receives Social Security benefits. How does he enroll in Original Medicare? - ✔✔His enrollment in Medicare Parts A and B is generally automatic if he 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? - ✔✔When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA plan. Which of the following are eligibility requirements for enrollment in a Medicare Advantage Plan? (Select

    • ✔✔-Is entitled to Medicare Part A
  • Is enrolled in Medicare Part B
  • Resides in the plan's service area Which of the following is a correct statement about in-network provider services? - ✔✔HMO Plans cover only in-network services. In most cases, members pay the full cost of any out-of-network services received, with a few important exceptions. Which of the following is NOT a correct statement about in-network provider services? - ✔✔HMO-POS Plans only cover in-network services. 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? - ✔✔The Out-of-Pocket Maximum will include her costs toward any Medicare-covered Part A or B services but does not include the cost of any plan premiums.

Margaret currently has an MAPD Plan. What would happen if you enrolled her into a stand-alone PDP? - ✔✔She would be disenrolled automatically from her MAPD Plan. Which of the following best describes eligibility to enroll in a stand-alone Prescription Drug Plan? - ✔✔Entitled to Part A and/or enrolled in Part B and reside in the plan service area. Aside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage, how else could a Medicare-eligible consumer get Part D prescription drug coverage? - ✔✔They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP). Which of the following statements is NOT true about the Coverage Gap? - ✔✔All members reach the Coverage Gap. Which of these statements is NOT true about the drug utilization management (UM) rules? - ✔✔ Which of the following best describes the Late Enrollment Penalty (LEP)? - ✔✔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. Through which means is financial assistance offered to a consumer who qualifies for Low Income Subsidy for their part of Medicare Part D costs? - ✔✔Through subsidies such as lower or no monthly plan premiums and lower or no copayments. Formulary is defined as: - ✔✔A list of medications covered within the benefit plan, based on CMS guidelines and developed in collaboration with physicians and pharmacists. 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. - ✔✔True What kind of financial assistance does a consumer receive who qualifies for Low Income Subsidy - ✔✔Lower or no monthly plan premiums and lower or no copayments