UHC CERTIFICATION EXAM NEWEST 2024-2025 FINAL EXAM
WITH COMPLETE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) GRADED A+
Medicare - ANSWER-Federal health insurance program
Medicare is administered by whom? - ANSWER-CMS (Centers for Medi-care and medical services)
Parts A & B of Medi-care are - ANSWER-federal health insurance program referred to as original
Medicare
Part A? - ANSWER-Hospital insurance
Part B? - ANSWER-Medical insurance
What doesn’t Medicare cover? - ANSWER-routine dental, eye care hearing exam deductibles,
coinsurance and copayments
Part C? - ANSWER-Medicare Advantage Plans
MA covers? - ANSWER-Part A &B coverage, and some part D coverage
MA plans are not? - ANSWER-Medicare supplement insurance plans
What offers lower monthly premiums MADP or supplement? - ANSWER-MADP
do MAP's have a annual maximum OOP maximum that limits the amount of money a member must
spend every year for covered services? - ANSWER-YES
, MA plans integrate what type of additional coverage? - ANSWER-part D prescription drug coverage
If a customer wants to keep their stand- alone prescription drug plan, what may the customer want to
enroll in? - ANSWER-MA-only PFFS plan
What is a stand- alone drug plan called? - ANSWER-PDP
What is PFFS? - ANSWER-Private Fee for Service (PFFS) - Plans that allow you to go to any doctor or
hospital that accepts their terms
If a customer lives in a rural area, what type of plan may they want because it gives them freedom to
access doctors that may not be in their network? - ANSWER-PFFS plan
Do HMO's require referals? - ANSWER-Yes
Do PPO's require a referal? - ANSWER-No
When a member enrolls in a MA plan, they receive their coverage from Medi-care or the MA plan? -
ANSWER-MA plan
When a customer is enrolled in a MA plan, they must continue paying their premiums for what other
plan? - ANSWER-Part B
MA plans have a maxium annual limit on OOP costs called a? - ANSWER-MOOP amount (Maxium out of
pocket)
When a member is 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_____? - ANSWER-effective
date
An exception exists for MA-only PFFS plans as a member can also be enrolled in a what? - ANSWER-
Stand- alone PDP
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