UHC Medicare Basics Assessment questions
and answers 2025\2026 A+ Grade
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?
- correct 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?
- correct answer The consumer must be in a valid MA election or disenrollment period.
Provided other eligibility requirements are met, who is eligible for Medicare?
- correct 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)
- correct 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?
- correct answer Medicare Advantage
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 are MA Plans that focus on using network providers to maximize the benefits and
reduce out-of-network expenses?
- correct answer HMO, POS, PPO
When does Medicare Supplement Open Enrollment take place?
- correct 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?
- correct 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?
- correct 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?
- correct 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?
- correct 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?
- correct answer A stand-alone Part D Plan.
Which of the following statements accurately describes a prescription drug stage?
- correct 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.
and answers 2025\2026 A+ Grade
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?
- correct 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?
- correct answer The consumer must be in a valid MA election or disenrollment period.
Provided other eligibility requirements are met, who is eligible for Medicare?
- correct 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)
- correct 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?
- correct answer Medicare Advantage
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 are MA Plans that focus on using network providers to maximize the benefits and
reduce out-of-network expenses?
- correct answer HMO, POS, PPO
When does Medicare Supplement Open Enrollment take place?
- correct 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?
- correct 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?
- correct 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?
- correct 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?
- correct 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?
- correct answer A stand-alone Part D Plan.
Which of the following statements accurately describes a prescription drug stage?
- correct 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.
