UHC MEDICARE BASICS EXAM AND PRACTICE
EXAM NEWEST 2024 ACTUAL EXAM COMPLETE 150
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY 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? - ANSWER 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? - ANSWER The consumer must be
in a valid MA election or disenrollment period.
Provided other eligibility requirements are met, who is eligible for Medicare? - ANSWER
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) - ANSWER
-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? - ANSWER Medicare Advantage
Which of the following statements is correct about HMO MA Plans? - ANSWER
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? - ANSWER HMO, POS, PPO
When does Medicare Supplement Open Enrollment take place? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? -
ANSWER 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? - ANSWER A stand-alone Part D Plan.
Which of the following statements accurately describes a prescription drug stage? -
ANSWER 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? - ANSWER 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 ______________. - ANSWER 63 or more continuous
days
How does a consumer who qualifies for Low Income Subsidy receive financial
assistance for their part of Medicare Part D costs? - ANSWER Through subsidies such
as lower or no monthly plan premiums and lower or no copayments.
Which of the following is a characteristic of a drug tier? - ANSWER All of the drugs in
the tier have the same copayment or coinsurance.
Which of the following is true about Medicare Supplement Insurance underwriting
criteria in states where underwriting applies? - ANSWER Underwriting is required if the
consumer is not in their Medicare Supplement Open Enrollment period or does not meet
Guaranteed Issue criteria.
EXAM NEWEST 2024 ACTUAL EXAM COMPLETE 150
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY 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? - ANSWER 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? - ANSWER The consumer must be
in a valid MA election or disenrollment period.
Provided other eligibility requirements are met, who is eligible for Medicare? - ANSWER
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) - ANSWER
-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? - ANSWER Medicare Advantage
Which of the following statements is correct about HMO MA Plans? - ANSWER
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? - ANSWER HMO, POS, PPO
When does Medicare Supplement Open Enrollment take place? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? -
ANSWER 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? - ANSWER A stand-alone Part D Plan.
Which of the following statements accurately describes a prescription drug stage? -
ANSWER 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? - ANSWER 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 ______________. - ANSWER 63 or more continuous
days
How does a consumer who qualifies for Low Income Subsidy receive financial
assistance for their part of Medicare Part D costs? - ANSWER Through subsidies such
as lower or no monthly plan premiums and lower or no copayments.
Which of the following is a characteristic of a drug tier? - ANSWER All of the drugs in
the tier have the same copayment or coinsurance.
Which of the following is true about Medicare Supplement Insurance underwriting
criteria in states where underwriting applies? - ANSWER Underwriting is required if the
consumer is not in their Medicare Supplement Open Enrollment period or does not meet
Guaranteed Issue criteria.
