2026 UHC Extra Questions and Answers with
solutions MA Certification
Which type of MA Plan is an HMO plan that also covers certain benefits
out-of-network, generally at a higher cost? Medicare Supplement
Insurance Plan Private Fee-for-Service (PFFS) Point-of-Service (POS) Plan
Preferred Provider Organization (PPO) - ANSWER Preferred Provider
Organization (PPO)
Which statement is true about the MA out-of-pocket maximum? A
Medicare Advantage Prescription Drug Plan (MAPD) member's costs for
prescription drugs and any benefits not covered by Original Medicare
count toward the out-of-pocket maximum. All MA plans have an out-of-
pocket maximum to help limit the member's out-of-pocket costs for
Medicare-covered medical services. The out-of-pocket maximum amount
is determined by Medicare each year and is the same for all MA plans. -
ANSWER All MA plans have an out-of-pocket maximum to help limit the
member's out-of-pocket costs for Medicare-covered medical services.
Which consumer is eligible for a standalone Medicare Prescription Drug
Plan (PDP)? Sharon, who is not enrolled in Medicare Part A or Medicare
Part B, and lives in the plan's service area. Joseph, who is enrolled in
Medicare Part A and Medicare Part B and lives in the plan's service area.
Alice, who is enrolled only in Medicare Part A, but does not live in the
plan's service area. Alvin, who is enrolled only in Medicare Part B, but
does not live in the plan's service area. - ANSWER Joseph, who is
, enrolled in Medicare Part A and Medicare Part B and lives in the plan's
service area.
In what order do the 3 prescription drug coverage stages occur? Initial
Coverage, Deductible, Catastrophic Coverage Catastrophic Coverage,
Initial Coverage, Deductible Deductible, Initial Coverage, Catastrophic
Coverage Deductible, Catastrophic Coverage, Initial Coverage - ANSWER
Deductible, Initial Coverage, Catastrophic Coverage
Which of the following is true about Medicare Supplement Plans? They
are regulated by the Centers for Medicare & Medicaid Services (CMS).
Plan benefit amounts automatically update when Medicare changes cost
sharing amounts, such as deductibles, coinsurance and copayments.
They can only be purchased during the Annual Election Period (AEP). To
see a specialist, insured members must get referrals from a primary care
provider. - ANSWER Plan benefit amounts automatically update when
Medicare changes cost sharing amounts, such as deductibles,
coinsurance and copayments.
Which statements regarding Star Ratings are true? (Select 2) Star Ratings
are based on a plan's performance in several key areas, such as
detecting and preventing illness, ratings from patients, patient safety
and customer service. Medicare uses a 5-star rating system to illustrate
the plan's relative popularity in a market as measured by membership
and retention rates. Medicare uses a 5-star rating system to illustrate a
plan's performance and quality. - ANSWER Star Ratings are based on a
plan's performance in several key areas, such as detecting and
preventing illness, ratings from patients, patient safety and customer
service.
solutions MA Certification
Which type of MA Plan is an HMO plan that also covers certain benefits
out-of-network, generally at a higher cost? Medicare Supplement
Insurance Plan Private Fee-for-Service (PFFS) Point-of-Service (POS) Plan
Preferred Provider Organization (PPO) - ANSWER Preferred Provider
Organization (PPO)
Which statement is true about the MA out-of-pocket maximum? A
Medicare Advantage Prescription Drug Plan (MAPD) member's costs for
prescription drugs and any benefits not covered by Original Medicare
count toward the out-of-pocket maximum. All MA plans have an out-of-
pocket maximum to help limit the member's out-of-pocket costs for
Medicare-covered medical services. The out-of-pocket maximum amount
is determined by Medicare each year and is the same for all MA plans. -
ANSWER All MA plans have an out-of-pocket maximum to help limit the
member's out-of-pocket costs for Medicare-covered medical services.
Which consumer is eligible for a standalone Medicare Prescription Drug
Plan (PDP)? Sharon, who is not enrolled in Medicare Part A or Medicare
Part B, and lives in the plan's service area. Joseph, who is enrolled in
Medicare Part A and Medicare Part B and lives in the plan's service area.
Alice, who is enrolled only in Medicare Part A, but does not live in the
plan's service area. Alvin, who is enrolled only in Medicare Part B, but
does not live in the plan's service area. - ANSWER Joseph, who is
, enrolled in Medicare Part A and Medicare Part B and lives in the plan's
service area.
In what order do the 3 prescription drug coverage stages occur? Initial
Coverage, Deductible, Catastrophic Coverage Catastrophic Coverage,
Initial Coverage, Deductible Deductible, Initial Coverage, Catastrophic
Coverage Deductible, Catastrophic Coverage, Initial Coverage - ANSWER
Deductible, Initial Coverage, Catastrophic Coverage
Which of the following is true about Medicare Supplement Plans? They
are regulated by the Centers for Medicare & Medicaid Services (CMS).
Plan benefit amounts automatically update when Medicare changes cost
sharing amounts, such as deductibles, coinsurance and copayments.
They can only be purchased during the Annual Election Period (AEP). To
see a specialist, insured members must get referrals from a primary care
provider. - ANSWER Plan benefit amounts automatically update when
Medicare changes cost sharing amounts, such as deductibles,
coinsurance and copayments.
Which statements regarding Star Ratings are true? (Select 2) Star Ratings
are based on a plan's performance in several key areas, such as
detecting and preventing illness, ratings from patients, patient safety
and customer service. Medicare uses a 5-star rating system to illustrate
the plan's relative popularity in a market as measured by membership
and retention rates. Medicare uses a 5-star rating system to illustrate a
plan's performance and quality. - ANSWER Star Ratings are based on a
plan's performance in several key areas, such as detecting and
preventing illness, ratings from patients, patient safety and customer
service.
