UHC certification Exam With Possible
Solutions | Latest Exam 2026-2027 |
Graded A+
Medicare -ANSWER Federal health insurance program
Medicare is administered by whom? -ANSWER CMS ( Centers for medicare and
medicaid services)
Parts A & B of medicare are -ANSWER federal health insurance program referred to as
original medicare
Part A? -ANSWER Hospital insurance
Part B? -ANSWER Medical insurance
What doesnt medicare cover? -ANSWER routine dental, eye care hearing
exam,deductibles, coinsurance and copayments
Part C? -ANSWER Medicare Advantage Plans
MA covers? -ANSWER Part A &B coverage, and some part D coverage
MA plans are not? -ANSWER Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement? -ANSWER MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services? -ANSWER YES
MA plans integrate what type of additonal coverage? -ANSWER part D prescription drug
coverage
If a customer wants to keep their stand alone prescription drug plan, what may the
customer want to enroll in? -ANSWER MA-only PFFS plan
What is a stand alone drug plan called? -ANSWER PDP
WHat is PFFS? -ANSWER Private Fee for Service (PFFS) - Plans that allow you to go to
any doctor or hospital that accepts their terms
If a customer lives in a rural area, what type of plan may they want because it gives
them freedom to access doctors that may not be in their network? -ANSWER PFFS plan
, Do HMO's require referals? -ANSWER Yes
Do PPO's require a referal? -ANSWER No
When a member enrolls in a MA plan, they receive their coverage from medicare or the
MA plan? -ANSWER MA plan
When a customer is enrolled in a MA plan, they must continue paying their premiums
for what other plan? -ANSWER Part B
MA plans have a maxium annual limit on OOP costs called a? -ANSWER MOOP amount
( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automatically disenrolled from any
other MA plan or PDP( prescription drug plan) in which they are enrolled as of the new
plans_____? -ANSWER effective date
An exception exisits for MA-only PFFS plans as a member can also be enrolled in a
what? -ANSWER Stand alone PDP
If a member enrolls in a MA plan, what must the member do? -ANSWER Cancel in writing
their medicare supplement insurance policy with the carrier after their request to enroll
in MA plan has been approved.
Medicare supplement insurance policies cannot be used in conjunction with what type
of plan? -ANSWER MA plan
A medicare supplement insurance plan helps to cover some of the OOP costs
associated with? -ANSWER original medicare.
A medicare supplement insurance plan does NOT pay the cost-sharing of what type of
plan? -ANSWER MA plan
when a client enrolls in a MA plan, will it automatically terminate their MA plan? -
ANSWER NO
Can a customer call to terminate their Med Sup plan? -ANSWER no it must be done in
writing
What are the different types of MA plans? -ANSWER HMO, POS, PPO, RPPO, PFFS,
SNP, and MSA
For an HMO, they customer must us IN network providers, what are the exceptions to
their rule? -ANSWER Emergencies, Urgent care, and renal dialysis services.
Solutions | Latest Exam 2026-2027 |
Graded A+
Medicare -ANSWER Federal health insurance program
Medicare is administered by whom? -ANSWER CMS ( Centers for medicare and
medicaid services)
Parts A & B of medicare are -ANSWER federal health insurance program referred to as
original medicare
Part A? -ANSWER Hospital insurance
Part B? -ANSWER Medical insurance
What doesnt medicare cover? -ANSWER routine dental, eye care hearing
exam,deductibles, coinsurance and copayments
Part C? -ANSWER Medicare Advantage Plans
MA covers? -ANSWER Part A &B coverage, and some part D coverage
MA plans are not? -ANSWER Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement? -ANSWER MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a
member must spend every year for covered services? -ANSWER YES
MA plans integrate what type of additonal coverage? -ANSWER part D prescription drug
coverage
If a customer wants to keep their stand alone prescription drug plan, what may the
customer want to enroll in? -ANSWER MA-only PFFS plan
What is a stand alone drug plan called? -ANSWER PDP
WHat is PFFS? -ANSWER Private Fee for Service (PFFS) - Plans that allow you to go to
any doctor or hospital that accepts their terms
If a customer lives in a rural area, what type of plan may they want because it gives
them freedom to access doctors that may not be in their network? -ANSWER PFFS plan
, Do HMO's require referals? -ANSWER Yes
Do PPO's require a referal? -ANSWER No
When a member enrolls in a MA plan, they receive their coverage from medicare or the
MA plan? -ANSWER MA plan
When a customer is enrolled in a MA plan, they must continue paying their premiums
for what other plan? -ANSWER Part B
MA plans have a maxium annual limit on OOP costs called a? -ANSWER MOOP amount
( Maxium out of pocket)
When a member is enrolled in a MA plan, they are automatically disenrolled from any
other MA plan or PDP( prescription drug plan) in which they are enrolled as of the new
plans_____? -ANSWER effective date
An exception exisits for MA-only PFFS plans as a member can also be enrolled in a
what? -ANSWER Stand alone PDP
If a member enrolls in a MA plan, what must the member do? -ANSWER Cancel in writing
their medicare supplement insurance policy with the carrier after their request to enroll
in MA plan has been approved.
Medicare supplement insurance policies cannot be used in conjunction with what type
of plan? -ANSWER MA plan
A medicare supplement insurance plan helps to cover some of the OOP costs
associated with? -ANSWER original medicare.
A medicare supplement insurance plan does NOT pay the cost-sharing of what type of
plan? -ANSWER MA plan
when a client enrolls in a MA plan, will it automatically terminate their MA plan? -
ANSWER NO
Can a customer call to terminate their Med Sup plan? -ANSWER no it must be done in
writing
What are the different types of MA plans? -ANSWER HMO, POS, PPO, RPPO, PFFS,
SNP, and MSA
For an HMO, they customer must us IN network providers, what are the exceptions to
their rule? -ANSWER Emergencies, Urgent care, and renal dialysis services.
