UHC CERTIFICATION EXAM
QUESTIONS AND VERIFIED
ANSWERS 2026
▶ Which of the following consumers would be eligible for Medicare?
Answer: -Consumers age 65 or older and consumers under 65 years of
age with certain disabilities except for ESRD or ALS
-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(right)
-Only consumers age 65 or older with certain disabilities and consumers of
all ages with ESRD or ALS
-Consumers age 62 or older, consumers under 62 years of age with certain
disabilities 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 does not have to provide benefits equivalent to
Original Medicare.(wrong)
-An MA Plans is part of Medicare and is also called Part C.(right)
-An MA Plan is a health plan option approved by Medicare and offered by
private insurance companies.(right)
-An MA Plan provides Medicare hospital and medical insurance (Medicare
Part A and Part B) and often include Medicare prescription drug coverage
(Part D).(right
▶ Janice wants to enroll in a 2021 Medicare Advantage plan. What
eligibility requirements must she meet? (Select the two answers that apply.)
Answer: -Not have End Stage Renal Disease (permanent kidney failure)
-Reside in the plan's service area(right)
-Entitled to Medicare Part A and enrolled in Part B(right)
-Entitled to Medicare Part A and/or is enrolled in Part B
▶ Which of the following statements is correct about HMO MA Plans?
Answer: -Members that use out-of-network providers for routine office visits
must pay a penalty in addition to any copayment.(wrong)
, -Most benefits are covered out-of-network but at a higher cost.
-Members must receive covered services from contracted network
providers.
-There are no exceptions to the provider network requirement for obtaining
certain services from out-of-network providers.
▶ Which type of MA Plan is an HMO plan that also covers some benefits
out-of-network, generally at a higher cost? Answer: -Private Fee-for-
Service (PFFS)
-Medicare Supplement Insurance Plan
-Preferred Provider Organization (PPO)
-Point-of-Service (POS) Plan(right)
▶ When does Medicare Supplement Open Enrollment take place?
Answer: -During the first three months a consumer is 65 or older and
enrolled in Medicare Part B.
-During the first six months a consumer is 65 or older and enrolled in
Medicare Part B.(right)
-Annually from October 15 to December 7.
-During the three months prior to the consumer's 65th birthday, the month
of their birthday, and the three months following the month of their 65th
birthday and enrolled in Medicare Part B.
▶ A consumer with Original Medicare might be interested in an MA Plan
because: Answer: -MA Plans eliminate Medicare Part A premiums.
-By joining an MA Plan they will no longer be a part of the Medicare
program.
-MA Plans typically provide additional coverage beyond Original Medicare
and often have established copayments for some benefits.(right)
-It has a larger network of providers and skilled nursing facilities.
▶ 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 should submit to their Medicare Supplement Insurance carrier
a written request to cancel his/her policy.(right)
-The member must submit a written request to cancel their Medicare
Supplement Insurance Plan the same day they submit their MA Plan
enrollment application.
QUESTIONS AND VERIFIED
ANSWERS 2026
▶ Which of the following consumers would be eligible for Medicare?
Answer: -Consumers age 65 or older and consumers under 65 years of
age with certain disabilities except for ESRD or ALS
-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(right)
-Only consumers age 65 or older with certain disabilities and consumers of
all ages with ESRD or ALS
-Consumers age 62 or older, consumers under 62 years of age with certain
disabilities 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 does not have to provide benefits equivalent to
Original Medicare.(wrong)
-An MA Plans is part of Medicare and is also called Part C.(right)
-An MA Plan is a health plan option approved by Medicare and offered by
private insurance companies.(right)
-An MA Plan provides Medicare hospital and medical insurance (Medicare
Part A and Part B) and often include Medicare prescription drug coverage
(Part D).(right
▶ Janice wants to enroll in a 2021 Medicare Advantage plan. What
eligibility requirements must she meet? (Select the two answers that apply.)
Answer: -Not have End Stage Renal Disease (permanent kidney failure)
-Reside in the plan's service area(right)
-Entitled to Medicare Part A and enrolled in Part B(right)
-Entitled to Medicare Part A and/or is enrolled in Part B
▶ Which of the following statements is correct about HMO MA Plans?
Answer: -Members that use out-of-network providers for routine office visits
must pay a penalty in addition to any copayment.(wrong)
, -Most benefits are covered out-of-network but at a higher cost.
-Members must receive covered services from contracted network
providers.
-There are no exceptions to the provider network requirement for obtaining
certain services from out-of-network providers.
▶ Which type of MA Plan is an HMO plan that also covers some benefits
out-of-network, generally at a higher cost? Answer: -Private Fee-for-
Service (PFFS)
-Medicare Supplement Insurance Plan
-Preferred Provider Organization (PPO)
-Point-of-Service (POS) Plan(right)
▶ When does Medicare Supplement Open Enrollment take place?
Answer: -During the first three months a consumer is 65 or older and
enrolled in Medicare Part B.
-During the first six months a consumer is 65 or older and enrolled in
Medicare Part B.(right)
-Annually from October 15 to December 7.
-During the three months prior to the consumer's 65th birthday, the month
of their birthday, and the three months following the month of their 65th
birthday and enrolled in Medicare Part B.
▶ A consumer with Original Medicare might be interested in an MA Plan
because: Answer: -MA Plans eliminate Medicare Part A premiums.
-By joining an MA Plan they will no longer be a part of the Medicare
program.
-MA Plans typically provide additional coverage beyond Original Medicare
and often have established copayments for some benefits.(right)
-It has a larger network of providers and skilled nursing facilities.
▶ 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 should submit to their Medicare Supplement Insurance carrier
a written request to cancel his/her policy.(right)
-The member must submit a written request to cancel their Medicare
Supplement Insurance Plan the same day they submit their MA Plan
enrollment application.
