lOMoAR cPSD| 25973474
2023 Updated UHC certifications
QUESTIONSWITH COMPLETE
SOLUTIONS
Lisa turned 65 and is now eligible for Medicare. She already receives Social
Security benefits. How does she enroll in Original Medicare? Correct 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? Correct 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? Correct Answer: Original Medicare
Which of the following defines a Medicare Advantage (MA) Plan? (Select 2)
Correct 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? Correct 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? Correct
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? Correct 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? Correct 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? Correct 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? Correct 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? Correct 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? Correct
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) Correct
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? Correct Answer: A deductible is the amount the member must pay for
every prescription medication, regardless of what stage they are in.
2023 Updated UHC certifications
QUESTIONSWITH COMPLETE
SOLUTIONS
Lisa turned 65 and is now eligible for Medicare. She already receives Social
Security benefits. How does she enroll in Original Medicare? Correct 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? Correct 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? Correct Answer: Original Medicare
Which of the following defines a Medicare Advantage (MA) Plan? (Select 2)
Correct 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? Correct 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? Correct
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? Correct 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? Correct 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? Correct 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? Correct 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? Correct 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? Correct
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) Correct
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? Correct Answer: A deductible is the amount the member must pay for
every prescription medication, regardless of what stage they are in.
