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UHC CERTIFICATION 2025 UPDATED
ACTUAL EXAM WITH CORRECT
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.
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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.
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(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
UHC CERTIFICATION 2025 UPDATED
ACTUAL EXAM WITH CORRECT
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 | Page
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.
, 3 | Page
(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
