UHC CERTIFICATION 2 LATEST VERSIONS
2024-2025 ACTUAL EXAM 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS
Leave the first rating
Terms in this set (157)
Medicare Federal health insurance program
Medicare is administered CMS ( Centers for medicare and medicaid services)
by whom?
Parts A & B of medicare federal health insurance program referred to as
are original medicare
Part A? Hospital insurance
Part B? Medical insurance
What doesnt medicare routine dental, eye care hearing exam,deductibles,
cover? coinsurance and copayments
Part C? Medicare Advantage Plans
MA covers? Part A &B coverage, and some part D coverage
MA plans are not? Medicare supplement insurance plans
What offers lower MADP
monthly premiums MADP
or supplement?
do MAP's have a annual YES
maximum OOP maximum
that limits the amount of
money a member must
spend every year for
covered services?
,MA plans integrate what part D prescription drug coverage
type of additonal
coverage?
If a customer wants to MA-only PFFS plan
keep their stand alone
prescription drug plan,
what may the customer
want to enroll in?
What is a stand alone PDP
drug plan called?
Private Fee for Service (PFFS) - Plans that allow you
WHat is PFFS? to go to any doctor or hospital that accepts their
terms
If a customer lives in a PFFS plan
rural area, what type of
plan may they want
because it gives them
freedom to access
doctors that may not be
in their network?
Do HMO's require Yes
referals?
Do PPO's require a No
referal?
When a member enrolls MA plan
in a MA plan, they receive
their coverage from
medicare or the MA
plan?
When a customer is Part B
enrolled in a MA plan,
they must continue
paying their premiums for
what other plan?
, MA plans have a maxium MOOP amount ( Maxium out of pocket)
annual limit on OOP
costs called a?
When a member is effective date
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_____?
An exception exisits for Stand alone PDP
MA-only PFFS plans as a
member can also be
enrolled in a what?
If a member enrolls in a Cancel in writing their medicare supplement
MA plan, what must the insurance policy with the carrier after their request
member do? to enroll in MA plan has been approved.
Medicare supplement MA plan
insurance policies cannot
be used in conjunction
with what type of plan?
A medicare supplement original medicare.
insurance plan helps to
cover some of the OOP
costs associated with?
A medicare supplement MA plan
insurance plan does NOT
pay the cost-sharing of
what type of plan?
when a client enrolls in a NO
MA plan, will it
automatically terminate
their MA plan?
2024-2025 ACTUAL EXAM 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS
Leave the first rating
Terms in this set (157)
Medicare Federal health insurance program
Medicare is administered CMS ( Centers for medicare and medicaid services)
by whom?
Parts A & B of medicare federal health insurance program referred to as
are original medicare
Part A? Hospital insurance
Part B? Medical insurance
What doesnt medicare routine dental, eye care hearing exam,deductibles,
cover? coinsurance and copayments
Part C? Medicare Advantage Plans
MA covers? Part A &B coverage, and some part D coverage
MA plans are not? Medicare supplement insurance plans
What offers lower MADP
monthly premiums MADP
or supplement?
do MAP's have a annual YES
maximum OOP maximum
that limits the amount of
money a member must
spend every year for
covered services?
,MA plans integrate what part D prescription drug coverage
type of additonal
coverage?
If a customer wants to MA-only PFFS plan
keep their stand alone
prescription drug plan,
what may the customer
want to enroll in?
What is a stand alone PDP
drug plan called?
Private Fee for Service (PFFS) - Plans that allow you
WHat is PFFS? to go to any doctor or hospital that accepts their
terms
If a customer lives in a PFFS plan
rural area, what type of
plan may they want
because it gives them
freedom to access
doctors that may not be
in their network?
Do HMO's require Yes
referals?
Do PPO's require a No
referal?
When a member enrolls MA plan
in a MA plan, they receive
their coverage from
medicare or the MA
plan?
When a customer is Part B
enrolled in a MA plan,
they must continue
paying their premiums for
what other plan?
, MA plans have a maxium MOOP amount ( Maxium out of pocket)
annual limit on OOP
costs called a?
When a member is effective date
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_____?
An exception exisits for Stand alone PDP
MA-only PFFS plans as a
member can also be
enrolled in a what?
If a member enrolls in a Cancel in writing their medicare supplement
MA plan, what must the insurance policy with the carrier after their request
member do? to enroll in MA plan has been approved.
Medicare supplement MA plan
insurance policies cannot
be used in conjunction
with what type of plan?
A medicare supplement original medicare.
insurance plan helps to
cover some of the OOP
costs associated with?
A medicare supplement MA plan
insurance plan does NOT
pay the cost-sharing of
what type of plan?
when a client enrolls in a NO
MA plan, will it
automatically terminate
their MA plan?
