UHC BASIC KB22 Questions and Answers (Verified
Answers)
Which of the following best defines Medicare Part D?
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 statements is true about eligibility requirements for stand-
alone Medicare Prescription Drug Plans?
A consumer must be entitled to Medicare Part A and/or enrolled in Medicare Part B
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
Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit
and Limited Access are all examples of what?
Utilization Management 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.
Can a consumer who qualifies for Low Income Subsidy receive financial
assistance for their part of Medicare Part D costs?
Yes, through subsidies such as lower or no monthly plan premiums and lower or no
copayments
Which of the following lists drug tiers from least expensive cost share to most
expensive cost share?
Preferred Generics, Generics, Preferred Brand (and some higher-cost generics), Non-
Preferred Drug (and some higher-cost generics), Specialty
Which of the following is true about Medicare Supplement Insurance underwriting
criteria in states where underwriting applies?
Underwriting is required if the consumer is not in their Medicare Supplement Open
Enrollment period or does not meet Guaranteed Issue criteria.
Which of the following is NOT true about the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA) impact to Plans C and F?
Consumers already enrolled in Plans C or F are required to change plans.
Which statement is true of Medicare Supplement Insurance Plans?
Insured members have the freedom to choose any doctor who accepts Medicare
patients.
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
Answers)
Which of the following best defines Medicare Part D?
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 statements is true about eligibility requirements for stand-
alone Medicare Prescription Drug Plans?
A consumer must be entitled to Medicare Part A and/or enrolled in Medicare Part B
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
Step Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit
and Limited Access are all examples of what?
Utilization Management 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.
Can a consumer who qualifies for Low Income Subsidy receive financial
assistance for their part of Medicare Part D costs?
Yes, through subsidies such as lower or no monthly plan premiums and lower or no
copayments
Which of the following lists drug tiers from least expensive cost share to most
expensive cost share?
Preferred Generics, Generics, Preferred Brand (and some higher-cost generics), Non-
Preferred Drug (and some higher-cost generics), Specialty
Which of the following is true about Medicare Supplement Insurance underwriting
criteria in states where underwriting applies?
Underwriting is required if the consumer is not in their Medicare Supplement Open
Enrollment period or does not meet Guaranteed Issue criteria.
Which of the following is NOT true about the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA) impact to Plans C and F?
Consumers already enrolled in Plans C or F are required to change plans.
Which statement is true of Medicare Supplement Insurance Plans?
Insured members have the freedom to choose any doctor who accepts Medicare
patients.
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
